Healthcare Provider Details
I. General information
NPI: 1508928987
Provider Name (Legal Business Name): CLARIN HAVIG R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10045 E MADERO AVE
MESA AZ
85209-1399
US
IV. Provider business mailing address
140 S GILBERT RD
GILBERT AZ
85296-1016
US
V. Phone/Fax
- Phone: 480-984-8947
- Fax: 480-354-5090
- Phone: 480-545-3826
- Fax: 480-632-4731
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WS0200X |
| Taxonomy | School Registered Nurse |
| License Number | RN068914 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: