Healthcare Provider Details

I. General information

NPI: 1932351350
Provider Name (Legal Business Name): JOANN G HAYSLIP RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8505 E VALLEY VIEW RD
SCOTTSDALE AZ
85250-6768
US

IV. Provider business mailing address

8505 E VALLEY VIEW
SCOTTSDALE AZ
85250
US

V. Phone/Fax

Practice location:
  • Phone: 480-484-5077
  • Fax:
Mailing address:
  • Phone: 480-484-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN049185
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN049185
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: