Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 04-42127 | KS |
N | 207P00000X | Emergency Physician | P9873 | TX |
N | 207R00000X | Internist | 04-42127 | KS |
N | 111NI0900X | Internist | 04-42127 | KS |
Y | 207R00000X | Internist | P9873 | TX |
Y | 111NI0900X | Internist | P9873 | TX |
N | 207RA0401X | Internist - Addiction Medicine | 04-42127 | KS |
NPI | 1417184680 |
---|---|
Provider Name | Ashley M R Haynes |
First Address | Andover, KS 67002-7982 |
Second Address | Wichita, KS 67203-3608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 22/09/2021 |