| Doctor Name: | POLLY ANNE HASKINS |
| NPI Number: | 1194035782 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 209.008397 |
| Business Practice Address: | 465 Avenue Of The Cities Suite 100 East Moline, IL - 61244 |
| Business Phone Number: | 3097795670 |
| Business Fax Number: | 3097795675 |
| Mailing Address: | 465 Avenue Of The Cities, Suite 100 EAST MOLINE |
| State: | IL |
| Postal Code: | 61244 |
| Phone Number: | 5154719728 |
| Fax Number: | 5154719319 |
| NPI Enumeration Date: | 10/15/2010 |
| NPI Last Update Date: | 02/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209.008397 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |