Provider Demographics
NPI:1417707167
Name:HAUGHTON, VANESSA (PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:HAUGHTON
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 W 25TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5057
Mailing Address - Country:US
Mailing Address - Phone:240-318-6786
Mailing Address - Fax:
Practice Address - Street 1:24 W 25TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5057
Practice Address - Country:US
Practice Address - Phone:240-318-6786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDY7P6Z8S8246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty