Provider Demographics
NPI:1568172831
Name:HASKINS, JADE DENISE (FNP)
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:DENISE
Last Name:HASKINS
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 1:10508 ASPEN HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-4501
Mailing Address - Country:US
Mailing Address - Phone:540-287-7861
Mailing Address - Fax:
Practice Address - Street 1:121 COURTHOUSE LN
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:VA
Practice Address - Zip Code:22427-9336
Practice Address - Country:US
Practice Address - Phone:804-633-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185885363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily