Provider Demographics
NPI:1548405566
Name:FOOTE, DRUCILLA HAINES (MS, PNP)
Entity type:Individual
Prefix:MS
First Name:DRUCILLA
Middle Name:HAINES
Last Name:FOOTE
Suffix:
Gender:F
Credentials:MS, PNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:744 52ND ST.
Mailing Address - Street 2:DEPT OF HEMATOLOGY/ONCOLOGY - CHILDREN'S HOSPITAL OAKLA
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609
Mailing Address - Country:US
Mailing Address - Phone:510-428-3347
Mailing Address - Fax:510-450-5648
Practice Address - Street 1:744 52ND ST.
Practice Address - Street 2:DEPT OF HEMATOLOGY/ONCOLOGY - CHILDREN'S HOSPITAL OAKLA
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-428-3347
Practice Address - Fax:510-450-5648
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA481790163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics