Provider Demographics
NPI:1154760403
Name:HASTON, WANDA M (RN)
Entity type:Individual
Prefix:MS
First Name:WANDA
Middle Name:M
Last Name:HASTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:WANDA
Other - Middle Name:M
Other - Last Name:ALLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12565 W CENTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3802
Mailing Address - Country:US
Mailing Address - Phone:402-342-5566
Mailing Address - Fax:402-342-0034
Practice Address - Street 1:12565 W CENTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3802
Practice Address - Country:US
Practice Address - Phone:402-342-5566
Practice Address - Fax:402-342-0034
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE36083163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse