Provider Demographics
NPI:1770760688
Name:HAYNES, AVIS ELAINE (PHD RN CNM FPNP)
Entity type:Individual
Prefix:MS
First Name:AVIS
Middle Name:ELAINE
Last Name:HAYNES
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Gender:F
Credentials:PHD RN CNM FPNP
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Mailing Address - Street 1:2500 N STATE STREET
Mailing Address - Street 2:UNIV OF MS MEDICAL CENTER OB-GYN DEPT
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-815-7300
Mailing Address - Fax:601-815-7355
Practice Address - Street 1:2500 NORTH STATE STREET
Practice Address - Street 2:WINFRED WISER WOMENS HOSPITAL
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-815-7300
Practice Address - Fax:601-815-7355
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
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Provider Licenses
StateLicense IDTaxonomies
MSR537985367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife