Provider Demographics
NPI:1932941762
Name:HASKINS, BRIANNA LYNN (RDH)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:LYNN
Last Name:HASKINS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:WAUNETA
Mailing Address - State:NE
Mailing Address - Zip Code:69045-0204
Mailing Address - Country:US
Mailing Address - Phone:308-350-0676
Mailing Address - Fax:
Practice Address - Street 1:404 W 10TH ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-2911
Practice Address - Country:US
Practice Address - Phone:308-345-4223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2856124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist