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General NPI Number Information
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NPI Number | 1114429107
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Entity Type | Individual
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Provider Name | ADDISON HASKINS CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | 132 S 10TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5244
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Country | US
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Telephone | 800-533-3669
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7776
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City | LANCASTER
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State | PA
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Zip | 17604-7776
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Country | US
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Telephone | 252-902-7028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00787300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP018411
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License Number State | PA
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