Individual
MARY JANE HASKEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
502 S OLD ORCHARD LN, SUITE 126, LEWISVILLE, TX 75067-4374
(972) 436-7962
(972) 353-5780
Mailing address
502 S OLD ORCHARD LN, SUITE 126, LEWISVILLE, TX 75067-4374
(972) 436-7962
(972) 353-5780
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
545514
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153212903
—
TX
01
—
545514
NURSE PRACTITIONERS
TX
Enumeration date
07/27/2006
Last updated
12/14/2021
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