Healthcare Provider Details

I. General information

NPI: 1215091327
Provider Name (Legal Business Name): MARGARET S HAYNER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET 'PEGGY' JONES

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 NW 4TH ST
REDMOND OR
97756-1502
US

IV. Provider business mailing address

PO BOX 460
REDMOND OR
97756-0088
US

V. Phone/Fax

Practice location:
  • Phone: 541-923-0119
  • Fax:
Mailing address:
  • Phone: 541-923-0119
  • Fax: 541-923-3228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201050173NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: