Provider Demographics
NPI:1235182627
Name:HAISLET, KARI NICOLE (ARNP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:NICOLE
Last Name:HAISLET
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:NICOLE
Other - Last Name:BAGBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2758
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50704-2758
Mailing Address - Country:US
Mailing Address - Phone:319-235-5390
Mailing Address - Fax:319-235-5607
Practice Address - Street 1:419 E DONALD STREET
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1223
Practice Address - Country:US
Practice Address - Phone:319-236-1911
Practice Address - Fax:319-287-5832
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH098529363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36079OtherWELLMARK INS PLAN
IA0448860Medicaid
IA421417307I1OtherJOHN DEERE HEALTH INS
IAI10976Medicare ID - Type Unspecified
IA0448860Medicaid