Provider Demographics
NPI:1326277823
Name:HAINES, CAROLYN G (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:G
Last Name:HAINES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:G
Other - Last Name:RAMSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:540 S COLLEGE AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1302
Mailing Address - Country:US
Mailing Address - Phone:302-831-3195
Mailing Address - Fax:302-831-3193
Practice Address - Street 1:540 S COLLEGE AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1302
Practice Address - Country:US
Practice Address - Phone:302-831-3195
Practice Address - Fax:302-831-3193
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000498363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DELG0000498OtherDE NP LICENSE