Provider Demographics
NPI:1275848871
Name:HAYNES, ERIN M (FPMHNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:HAYNES
Suffix:
Gender:F
Credentials:FPMHNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FPMHNP
Mailing Address - Street 1:PO BOX 7291
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8950
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:77 TRUMAN WAY
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:ME
Practice Address - Zip Code:04274-6153
Practice Address - Country:US
Practice Address - Phone:207-400-2674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP101045363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health