Provider Demographics
NPI:1790178986
Name:HAYNES, SIRENA
Entity Type:Individual
Prefix:
First Name:SIRENA
Middle Name:
Last Name:HAYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3363 WARRENSVILLE CENTER RD APT 206
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3745
Mailing Address - Country:US
Mailing Address - Phone:216-632-5549
Mailing Address - Fax:
Practice Address - Street 1:3363 WARRENSVILLE CENTER RD APT 206
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44122-3745
Practice Address - Country:US
Practice Address - Phone:216-632-5549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH526244163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse