Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN9263364 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN9263364 | FL |
NPI | 1033643440 |
---|---|
Provider Name | Lincoln Douglas Haynes |
First Address | Orlando, FL 32803-1248 |
Second Address | Orlando, FL 32803-1248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2017 |
Last Update Date | 20/10/2020 |