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NPI Code Detail

MEDICARE: LEONARD ANTHONY HAYNES CRNA

MEDICARE: LEONARD ANTHONY HAYNES CRNA
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
1163W00000XRegistered Nurse1129001TX
2367500000XCertified Registered Nurse Anesthetist1129001TX
3163W00000XRegistered NurseRN9538531FL
4367500000XCertified Registered Nurse Anesthetist8047NC

General Provider Information

NPI Number : 1679349492
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEONARD ANTHONY HAYNES CRNA
Provider Business Mailing Address
First Line : 100 KIMEL FOREST DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-6074
Country : US
Telephone Number : 336-716-2255
Fax Number :
Provider Business Practice Location Address
First Line : 5030 BRUNSON DR
Second Line :
City : CORAL GABLES
State : FL
Zip : 33146-2412
Country : US
Telephone Number : 347-932-7249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2023
Last Update Date : 03/12/2026

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