Provider Demographics
NPI:1942834676
Name:HAYNES, SHA ROBINSON (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SHA
Middle Name:ROBINSON
Last Name:HAYNES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 KATRINA CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-6924
Mailing Address - Country:US
Mailing Address - Phone:803-605-2666
Mailing Address - Fax:803-356-5675
Practice Address - Street 1:120 KATRINA CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-6924
Practice Address - Country:US
Practice Address - Phone:803-605-2666
Practice Address - Fax:803-356-5675
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251579163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator