Provider Demographics
NPI:1093533630
Name:HAVEN, EGLE D (APRN-FNP)
Entity type:Individual
Prefix:MRS
First Name:EGLE
Middle Name:D
Last Name:HAVEN
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 TAMIAMI TRL N STE 501
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4459
Mailing Address - Country:US
Mailing Address - Phone:239-237-4417
Mailing Address - Fax:239-237-4418
Practice Address - Street 1:2335 TAMIAMI TRL N STE 501
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4459
Practice Address - Country:US
Practice Address - Phone:239-237-4417
Practice Address - Fax:239-237-4418
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035400207Q00000X, 363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily