Healthcare Provider Details

I. General information

NPI: 1265822019
Provider Name (Legal Business Name): KATHRYN HAXTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2015
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 SAVANNAH RD BEEBE HEALTHCARE
LEWES DE
19958
US

IV. Provider business mailing address

424 SAVANNAH RD BEEBE HEALTHCARE
LEWES DE
19958
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3726
  • Fax: 302-645-3698
Mailing address:
  • Phone: 302-645-3726
  • Fax: 302-645-3698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberLI-0029026
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: