Healthcare Provider Details

I. General information

NPI: 1811862931
Provider Name (Legal Business Name): CHRISTINE V HAYNES DNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1266 CLUBHOUSE DR
ROCKLEDGE FL
32955-6790
US

IV. Provider business mailing address

1266 CLUBHOUSE DR
ROCKLEDGE FL
32955-6790
US

V. Phone/Fax

Practice location:
  • Phone: 267-575-2660
  • Fax:
Mailing address:
  • Phone: 267-575-2660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9574503
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9574503
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN9574503
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN9574503
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN9574503
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN9574503
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License NumberRN9574503
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: