Provider Demographics
NPI:1700211307
Name:HASKETT, NICHELLE GABRIELE
Entity Type:Individual
Prefix:MISS
First Name:NICHELLE
Middle Name:GABRIELE
Last Name:HASKETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 S. CLINTON ST.
Mailing Address - Street 2:UNIT 40
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80427
Mailing Address - Country:US
Mailing Address - Phone:720-684-8527
Mailing Address - Fax:
Practice Address - Street 1:4455 E. 12TH AVE.
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-504-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator