Provider Demographics
NPI:1508133315
Name:HAYNES, RONISHA L (RN)
Entity Type:Individual
Prefix:
First Name:RONISHA
Middle Name:L
Last Name:HAYNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5969 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-2907
Mailing Address - Country:US
Mailing Address - Phone:614-362-4404
Mailing Address - Fax:614-347-0831
Practice Address - Street 1:5969 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2907
Practice Address - Country:US
Practice Address - Phone:614-362-4404
Practice Address - Fax:614-347-0831
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH411823163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health