Provider Demographics
NPI:1487247730
Name:HAYNES, DANIELLE A
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:HAYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 ALTA ACRES LN
Mailing Address - Street 2:
Mailing Address - City:ASBURY
Mailing Address - State:WV
Mailing Address - Zip Code:24916-7001
Mailing Address - Country:US
Mailing Address - Phone:304-445-1128
Mailing Address - Fax:
Practice Address - Street 1:258 ALTA ACRES LN
Practice Address - Street 2:
Practice Address - City:ASBURY
Practice Address - State:WV
Practice Address - Zip Code:24916-7001
Practice Address - Country:US
Practice Address - Phone:304-445-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant