Provider Demographics
NPI:1053667642
Name:HASKINS, VANESA LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:VANESA
Middle Name:LYNN
Last Name:HASKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 S FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79110-1026
Mailing Address - Country:US
Mailing Address - Phone:806-374-5516
Mailing Address - Fax:806-373-4769
Practice Address - Street 1:3108 S FILLMORE ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79110-1026
Practice Address - Country:US
Practice Address - Phone:806-374-5516
Practice Address - Fax:806-373-4769
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX711819163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology