Provider Demographics
NPI:1871480376
Name:HAYNES, STEPHANIE LYNN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN
Last Name:HAYNES
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:PO BOX 959203
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-9203
Mailing Address - Country:US
Mailing Address - Phone:618-233-2220
Mailing Address - Fax:618-233-2555
Practice Address - Street 1:4600 MEMORIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5363
Practice Address - Country:US
Practice Address - Phone:618-233-2220
Practice Address - Fax:618-233-2555
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209.032558363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner