Provider Demographics
NPI:1679766836
Name:GOBIN, HAITRAM (RN)
Entity Type:Individual
Prefix:
First Name:HAITRAM
Middle Name:
Last Name:GOBIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 OAKGLEN WAY
Mailing Address - Street 2:APT # 244
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123
Mailing Address - Country:US
Mailing Address - Phone:786-253-5626
Mailing Address - Fax:
Practice Address - Street 1:873 SE OAK GLEN WAY
Practice Address - Street 2:APT # 244
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-6839
Practice Address - Country:US
Practice Address - Phone:786-253-5626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163W00000X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163W00000XNursing Service ProvidersRegistered Nurse