Provider Demographics
NPI:1154745099
Name:HAYNES, YOLANDA (RPH)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:HAYNES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9350 CORTANA PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-8603
Mailing Address - Country:US
Mailing Address - Phone:225-927-0114
Mailing Address - Fax:225-927-0066
Practice Address - Street 1:9350 CORTANA PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-8603
Practice Address - Country:US
Practice Address - Phone:225-927-0114
Practice Address - Fax:225-927-0066
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist