Provider Demographics
NPI:1093976888
Name:HASLUN, HEATHER F (FNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:F
Last Name:HASLUN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MACARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-3603
Mailing Address - Country:US
Mailing Address - Phone:518-234-8745
Mailing Address - Fax:518-234-8753
Practice Address - Street 1:132 MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-3603
Practice Address - Country:US
Practice Address - Phone:518-234-8745
Practice Address - Fax:518-234-8753
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335546-1173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF335546-1OtherNEW YORK STATE LICENSE
NYMH1782615OtherDEA