Provider Demographics
NPI:1922498278
Name:BAYNES, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:BAYNES
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:PO BOX 1255
Mailing Address - Street 2:
Mailing Address - City:WALKERTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27051-1255
Mailing Address - Country:US
Mailing Address - Phone:336-618-1674
Mailing Address - Fax:
Practice Address - Street 1:117 BROOKFIELD DR
Practice Address - Street 2:
Practice Address - City:STOKESDALE
Practice Address - State:NC
Practice Address - Zip Code:27357
Practice Address - Country:US
Practice Address - Phone:336-618-1674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP089387146N00000X
NC171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic