Provider Demographics
NPI:1184125684
Name:HAYNES, WADIYA (MSN, FNP-BC, CNRN)
Entity type:Individual
Prefix:
First Name:WADIYA
Middle Name:
Last Name:HAYNES
Suffix:
Gender:F
Credentials:MSN, FNP-BC, CNRN
Other - Prefix:
Other - First Name:WADIYA
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 67537
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-8009
Mailing Address - Country:US
Mailing Address - Phone:302-400-9999
Mailing Address - Fax:302-487-1167
Practice Address - Street 1:200 BANNING ST STE 280
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3489
Practice Address - Country:US
Practice Address - Phone:302-400-9999
Practice Address - Fax:302-487-1167
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001167363LF0000X
PASP018496363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner