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NPI Code Detail

MEDICARE: JUDITH LYNN HAYNES

MEDICARE:   JUDITH LYNN HAYNES
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
1374J00000XDoula
2374U00000XHome Health Aide9280454MI

General Provider Information

NPI Number : 1437900222
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH LYNN HAYNES
Provider Business Mailing Address
First Line : 1010 HOLLAND AVE STE 101
Second Line :
City : PORT HURON
State : MI
Zip : 48060-1535
Country : US
Telephone Number : 810-305-1567
Fax Number :
Provider Business Practice Location Address
First Line : 1010 HOLLAND AVE STE 101
Second Line :
City : PORT HURON
State : MI
Zip : 48060-1535
Country : US
Telephone Number : 810-305-1567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2024
Last Update Date : 07/17/2024

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Directions to “ JUDITH LYNN HAYNES ” Practice Location

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