Provider Demographics
NPI:1093041519
Name:HASLEY, CONNIE (CD (DONA))
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:HASLEY
Suffix:
Gender:F
Credentials:CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 LEFF ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4443
Mailing Address - Country:US
Mailing Address - Phone:805-215-0020
Mailing Address - Fax:
Practice Address - Street 1:1051 LEFF ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4443
Practice Address - Country:US
Practice Address - Phone:805-215-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DONA CERT. #4217374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula