Individual
KAILA HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2085 FRONTIS PLAZA BLVD, WINSTON SALEM, NC 27103-5614
(704) 316-4136
(704) 417-4814
Mailing address
PO BOX 604042, CHARLOTTE, NC 28260-4042
(704) 316-4136
(704) 417-4814
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5011512
NC
363LP0200X
Pediatric Nurse Practitioner
0024176493
VA
363LP0200X
Pediatric Nurse Practitioner
5011512
NC
Other
Enumeration date
08/11/2018
Last updated
07/31/2024
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