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Individual

MRS. ELISABETH ANN FULLER-HASKELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
253 PLEASANT LAKE AVE, HARWICH, MA 02645-2535
(508) 432-5233
(508) 430-0511
Mailing address
253 PLEASANT LAKE AVE, HARWICH, MA 02645-2535
(508) 432-5233
(508) 430-0511

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
160499
MA
363LG0600X
Gerontology Nurse Practitioner
160499
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0353761
MA
01
NP 0055
BCBS
MA
01
NP0055
BCBS
01
UX3415
PTAN
Enumeration date
10/23/2006
Last updated
01/08/2008
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