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General NPI Number Information
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NPI Number | 1275523193
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Entity Type | Individual
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Provider Name | CHRISTOPHER P HAYNES DNP
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Gender | Male
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Dates
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Enumeration Date | 10/22/2005
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Last Update Date | 07/09/2015
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Provider Practice Location Address
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Address Line | 640 JACKSON ST MAIL STOP 11302C
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City | ST. PAUL
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State | MN
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Zip | 55101-2502
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Country | US
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Telephone | 651-254-4786
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Fax | 651-254-9426
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MAIL STOP 21110Q
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City | BLOOMINGTON
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone | 651-254-2300
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Fax | 651-254-2301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 900422
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R165377-3
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R165377-3
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License Number State | MN
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