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Individual
ANTHONY KEALA HAVENS
Active
Individual
ANTHONY KEALA HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
758196
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403148
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
758196
RN LICENSE
NY
Enumeration date
10/03/2019
Last updated
11/19/2025
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