| Doctor Name: | MRS. ANDREA HAYNES |
| NPI Number: | 1053723676 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP-BC |
| License Number: | RN208594 |
| Business Practice Address: | 6231 Redan Overlook Lithonia, GA - 300587101 |
| Business Phone Number: | 4045123043 |
| Business Fax Number: | |
| Mailing Address: | 6231 Redan Overlook, LITHONIA |
| State: | GA |
| Postal Code: | 300587101 |
| Phone Number: | 4045123043 |
| Fax Number: | |
| NPI Enumeration Date: | 06/02/2014 |
| NPI Last Update Date: | 06/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN208594 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |