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General NPI Number Information
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NPI Number | 1396339636
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Entity Type | Individual
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Provider Name | ANGELA HAYNES
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Gender | Female
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | HIGHWAY 12 & N7
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City | FORT DEFIANCE
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State | AZ
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Zip | 86504-0589
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Country | US
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Telephone | 928-729-8132
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Fax | 928-729-8169
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Provider Business Mailing Address
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Address Line | 1210 W 132ND PL
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City | DENVER
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State | CO
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Zip | 80234-1188
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Country | US
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Telephone | 303-301-4883
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Fax |
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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 | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | 1820
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License Number State | CO
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