| Doctor Name: | AMY KATHERINE HAVERTY |
| NPI Number: | 1003019969 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PNP |
| License Number: | 660544 |
| Business Practice Address: | 301 University Blvd Galveston, TX - 775555302 |
| Business Phone Number: | 4097722222 |
| Business Fax Number: | |
| Mailing Address: | 301 University Blvd, GALVESTON |
| State: | TX |
| Postal Code: | 775555302 |
| Phone Number: | 4097722222 |
| Fax Number: | |
| NPI Enumeration Date: | 06/07/2007 |
| NPI Last Update Date: | 06/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 660544 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |