MEDICARE: KATRINA NIKOLE HASLETT MD

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
1	207V00000X	Obstetrics & Gynecology Physician	12811	NV

General Provider Information

NPI Number	:	1801893029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA NIKOLE HASLETT MD

Provider Business Mailing Address
First Line	:	8906 SPANISH RIDGE AVE STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1319
Country	:	US
Telephone Number	:	702-330-3102
Fax Number	:	702-912-4994

Provider Business Practice Location Address
First Line	:	5320 S RAINBOW BLVD STE 282
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1896
Country	:	US
Telephone Number	:	702-243-0202
Fax Number	:	702-262-9330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	01/16/2024

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