MEDICARE: DAMIA HAYMAN CFNP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1063758654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAMIA HAYMAN CFNP LLC

Provider Business Mailing Address
First Line	:	2415 JACKSON AVE
Second Line	:	1B
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-2042
Country	:	US
Telephone Number	:	304-812-5931
Fax Number	:	304-812-5933

Provider Business Practice Location Address
First Line	:	2415 JACKSON AVE
Second Line	:	1B
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-2042
Country	:	US
Telephone Number	:	304-812-5931
Fax Number	:	304-812-5933

Authorized Official
Title or Position	:	OWNER
Name	:	DAMIA HAYMAN
Credential	:
Telephone Number	:	304-812-5931

Provider Enumeration Date	:	12/31/2012
Last Update Date	:	12/12/2013

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