Haynie, Lisa

Haynie, Lisa is an individual health care provider with primary practice located at 1339 Oak Park Dr , Jackson MS 39213-6804. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Haynie, Lisa can be contacted via phone (601) 713-1642.

Contact Information

Primary practice address
1339 Oak Park Dr Jackson MS 39213-6804
Phone: (601) 713-1642
Fax: (601) 981-6213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R784342 Mississippi

Profile Details

NPI number 1811957905
LBN Legal business name Haynie, Lisa
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Sep 4th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811957905 NPPES
Mississippi MEDICAID 00119447

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