Provider Demographics
NPI:1497063119
Name:HAYNES, KIMBERLY KAY (RN, MS, DNP, APR)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:KAY
Last Name:HAYNES
Suffix:
Gender:F
Credentials:RN, MS, DNP, APR
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Mailing Address - Street 1:10730 NALL AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211
Mailing Address - Country:US
Mailing Address - Phone:913-945-7000
Mailing Address - Fax:913-645-9860
Practice Address - Street 1:10730 NALL AVE STE 201
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1210
Practice Address - Country:US
Practice Address - Phone:913-945-7000
Practice Address - Fax:913-945-9860
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS53-74782-0122086X0206X
KS5374782012364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology