Provider Demographics
NPI:1104158807
Name:HASKINS, CHELSEA SHAUNYELL (RN)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:SHAUNYELL
Last Name:HASKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4022 STIRRUP CREEK DR. STE. 315
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-4575
Mailing Address - Country:US
Mailing Address - Phone:919-425-3000
Mailing Address - Fax:919-425-3003
Practice Address - Street 1:4022 STIRRUP CREEK DR STE 315
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8999
Practice Address - Country:US
Practice Address - Phone:919-425-3000
Practice Address - Fax:919-425-3003
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC222458163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse