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NPI Code Detail

MEDICARE: MELINDA HASKETT BSN

MEDICARE: MELINDA HASKETT BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN141564TN

General Provider Information

NPI Number : 1023256195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINDA HASKETT BSN
Provider Business Mailing Address
First Line : 900 BUFFALO ST
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-6720
Country : US
Telephone Number : 423-232-4130
Fax Number : 423-467-3644
Provider Business Practice Location Address
First Line : 1167 SPRATLIN PARK DR
Second Line :
City : GRAY
State : TN
Zip : 37615-6205
Country : US
Telephone Number : 423-467-3721
Fax Number : 423-467-3644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2009
Last Update Date : 01/28/2009

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Directions to “ MELINDA HASKETT BSN” Practice Location

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