Provider Demographics
NPI:1932291929
Name:HASKELL, CHRISTINA RUTH (ANP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:RUTH
Last Name:HASKELL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 W BENSON BLVD
Mailing Address - Street 2:SUITE #315
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3679
Mailing Address - Country:US
Mailing Address - Phone:907-929-4009
Mailing Address - Fax:907-929-4902
Practice Address - Street 1:1400 W BENSON BLVD
Practice Address - Street 2:SUITE #525
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3679
Practice Address - Country:US
Practice Address - Phone:907-929-4009
Practice Address - Fax:907-929-4902
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK832363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP3247Medicaid
AKK162344Medicare PIN
Q51716Medicare UPIN