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General NPI Number Information
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NPI Number | 1467480699
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Entity Type | Individual
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Provider Name | JANICE KLAIBER HAYNES NP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5319 PARKSHIRE WAY
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City | N CHARLESTON
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State | SC
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Zip | 29418-2051
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Country | US
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Telephone | 843-767-2121
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Fax | 843-767-2102
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Provider Business Mailing Address
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Address Line | 135 CANDACE DR
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City | RIDGEVILLE
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State | SC
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Zip | 29472-8802
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Country | US
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Telephone | 843-871-5847
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Fax | 843-767-2102
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | OB518
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License Number State | SC
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