Individual
MISS BETHANY A HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 536-8969
(814) 536-7180
Mailing address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 536-8969
(814) 536-7180
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MA052224
PA
363AM0700X
Medical Physician Assistant
Primary
MA052224
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007708200001
—
PA
Enumeration date
12/13/2006
Last updated
06/20/2019
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