Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 164115 | MA |
NPI | 1023162476 |
---|---|
Provider Name | Ms. Linda G Haynes |
First Address | Boxford, MA 01921-2418 |
Second Address | Beverly, MA 01915-1790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |