KRISTA S POTTHAST-HAYNES
Nursing at Hacienda Del Mar Blvd A4, Placida, FL

License number
Florida 9181305
Issued Date
Aug 14, 2001
Effective Date
Mar 5, 2015
Expiration Date
Apr 30, 2019
Category
Health Care
Type
Registered Nurse
Address
Address
11220 Hacienda Del Mar Blvd, Placida, FL 33946
Phone
(310) 779-7296
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Organization information

See more information about KRISTA S POTTHAST-HAYNES at bizstanding.com

KRISTA S. POTTHAST-HAYNES, PA

Venice, FL  -  Placida, FL

Status:
Inactive
Inactive reason:
NAME CHANGE AMENDMENT
Registration:
Jul 22, 2014
Inactive since:
Aug 7, 2014
Addresses:
1380 Lemon Bay Dr, Venice, FL 34293 (Physical)
Placida, FL 33946 (Mailing)
PO Box 3785, Placida, FL 33946
State ID:
P14000061530
Business type:
Florida Profit Corporation
Presidents:
Potthast-Haynes, Krista S, 1380 Lemon Bay Dr, Venice, FL 34293 (Physical),Krista S. Potthast-Haynes (President)
Agent:
Korszen, Dorothy L, Esq,99 Nesbit St, Punta Gorda, FL 33950 (Physical)
EIN:
61-1744498

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