Provider Demographics
NPI:1912621392
Name:HAWS, MADELINE (APRN)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:HAWS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 N 860 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-8606
Mailing Address - Country:US
Mailing Address - Phone:801-368-2031
Mailing Address - Fax:
Practice Address - Street 1:922 W BAXTER DR STE 110
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8626
Practice Address - Country:US
Practice Address - Phone:385-281-9846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT104044814405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily