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NPI Code Detail

MEDICARE: MS. NICOLE HASKINS RN, CRNP

MEDICARE: MS. NICOLE HASKINS RN, CRNP
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
1363LF0000XFamily Nurse PractitionerR171119MD

General Provider Information

NPI Number : 1851344097
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE HASKINS RN, CRNP
Provider Business Mailing Address
First Line : 6400 MARLBORO PIKE
Second Line :
City : DISTRICT HEIGHTS
State : MD
Zip : 20747-2841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6400 MARLBORO PIKE
Second Line :
City : DISTRICT HEIGHTS
State : MD
Zip : 20747-2841
Country : US
Telephone Number : 301-736-7000
Fax Number : 301-736-6916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 08/27/2013

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