Provider Demographics
NPI:1871017186
Name:HAYNES, TYRA K (NREMT-P)
Entity Type:Individual
Prefix:MRS
First Name:TYRA
Middle Name:K
Last Name:HAYNES
Suffix:
Gender:F
Credentials:NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-1215
Mailing Address - Country:US
Mailing Address - Phone:337-288-3600
Mailing Address - Fax:
Practice Address - Street 1:536 WESTWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:337-288-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)