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Individual

MS. MARY SUSAN HASKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 392-2352
(970) 350-6454
Mailing address
PO BOX 286, GLEN HAVEN, CO 80532-0286
(970) 586-5173

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRA-4559
CO
367500000X
Certified Registered Nurse Anesthetist
RN562646
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45421331
CO
Enumeration date
06/09/2006
Last updated
06/01/2010
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