Haynes, Jennifer B

Haynes, Jennifer B is an individual health care provider with primary practice located at 3236 Holmestown Rd Suite E1, Myrtle Beach SC 29588-7495. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Haynes, Jennifer B can be contacted via phone (843) 663-8000.

Contact Information

Primary practice address
3236 Holmestown Rd Suite E1 Myrtle Beach SC 29588-7495
Phone: (843) 663-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN122940 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4031 South Carolina

Profile Details

NPI number 1235304023
LBN Legal business name Haynes, Jennifer B
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2008
Last updated Apr 1st, 2016 - about 8 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 1235304023 NPPES
South Carolina Other 4031 SC STATE LICENSE
South Carolina Other RN122940 SC STATE LICENSE
South Carolina MEDICAID 7004853 SC STATE LICENSE
South Carolina MEDICAID NP0413 SC STATE LICENSE

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