Holly Anne Haines, PA-C, RDN is a medicare enrolled "Physician Assistant" provider in Wright Patterson Afb, Ohio. Her current practice location is
4881 Sugar Maple Dr, Wright Patterson Afb, Ohio. You can reach out to her office (for appointments etc.) via phone at
(937) 522-2778.
Holly Anne Haines is licensed to practice in * (Not Available) (license number 1220046) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1477972768.
Healthcare Provider's Profile
Full Name | Holly Anne Haines |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 4881 Sugar Maple Dr, Wright Patterson Afb, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1477972768
- Provider Enumeration Date: 04/15/2014
- Last Update Date: 04/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 2365981081
- Enrollment ID: I20240827000175
Medical Identifiers
Medical identifiers for Holly Anne Haines such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477972768 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 1079535 (Idaho) | Secondary |
363A00000X | Physician Assistant | 1220046 (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holly Anne Haines is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Holly Anne Haines, PA-C, RDN 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 Ph: (379) 257-0402 | Holly Anne Haines, PA-C, RDN 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 Ph: (937) 522-2778 |
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