Provider Demographics
NPI:1144856105
Name:HASKINS, KASEY (RN)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:HASKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10726 72ND AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-5914
Mailing Address - Country:US
Mailing Address - Phone:625-489-3332
Mailing Address - Fax:
Practice Address - Street 1:6000 49TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2114
Practice Address - Country:US
Practice Address - Phone:727-521-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9496742163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscienceGroup - Single Specialty