Provider Demographics
NPI:1750350062
Name:HASKELL, JANET R (NPC CRNFA)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:R
Last Name:HASKELL
Suffix:
Gender:F
Credentials:NPC CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718
Mailing Address - Country:US
Mailing Address - Phone:520-795-7923
Mailing Address - Fax:520-320-2155
Practice Address - Street 1:2450 E RIVER RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718
Practice Address - Country:US
Practice Address - Phone:520-795-7923
Practice Address - Fax:520-320-2155
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN048143363L00000X, 364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ184987Medicaid
AZ184987Medicaid
S96044Medicare UPIN
84934Medicare ID - Type Unspecified