Provider Demographics
NPI:1316194939
Name:HAIKER, GEORGIA L (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:L
Last Name:HAIKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:GEORGIA
Other - Middle Name:L
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1567 MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-3458
Mailing Address - Country:US
Mailing Address - Phone:512-351-4405
Mailing Address - Fax:512-901-9765
Practice Address - Street 1:1567 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-3458
Practice Address - Country:US
Practice Address - Phone:512-351-4405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN044020363LF0000X
TXAP118602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB104704Medicare PIN