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General NPI Number Information
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NPI Number | 1427292903
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Entity Type | Individual
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Provider Name | LILLIAN MONISOLA HAASTRUP PMHCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 2200 W BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43223-1297
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Country | US
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Telephone | 614-752-0333
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Fax | 614-752-0383
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Provider Business Mailing Address
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Address Line | 2200 W BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43223-1297
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Country | US
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Telephone | 614-752-0333
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Fax | 614-752-0383
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN 341630
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN341630
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | NS-15433
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License Number State | OH
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