Healthcare Provider Details

I. General information

NPI: 1003361064
Provider Name (Legal Business Name): RHONDA JEANNEAN HAYNES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W 3RD AVE
ALBANY GA
31701-1943
US

IV. Provider business mailing address

212 BRIGHT WATER DR
LEESBURG GA
31763-4184
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-1000
  • Fax:
Mailing address:
  • Phone: 229-395-3250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN211603
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN211603
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: