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Individual

LAURIE HASKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
209 9TH ST, SUITE 200, ROCKFORD, IL 61104
(779) 696-2750
(779) 696-4196
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
(779) 696-7342

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0411232777
IL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
209013150
IL

Other

Enumeration date
07/31/2015
Last updated
02/19/2021
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