Provider Demographics
NPI:1659405728
Name:HASKETT, JOHN TIM (GNP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:TIM
Last Name:HASKETT
Suffix:
Gender:M
Credentials:GNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6860
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95502-6860
Mailing Address - Country:US
Mailing Address - Phone:707-443-3384
Mailing Address - Fax:707-443-3204
Practice Address - Street 1:4410 CHAFFIN RD
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-8029
Practice Address - Country:US
Practice Address - Phone:707-845-2570
Practice Address - Fax:888-960-9819
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA6064363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care