Provider Demographics
NPI:1447968359
Name:HASELTINE, ELIZABETH STRATTON (PA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:STRATTON
Last Name:HASELTINE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:STRATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4921 LONG PRAIRIE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2742
Mailing Address - Country:US
Mailing Address - Phone:972-691-8700
Mailing Address - Fax:972-691-8782
Practice Address - Street 1:4921 LONG PRAIRIE RD STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2742
Practice Address - Country:US
Practice Address - Phone:972-691-8700
Practice Address - Fax:972-691-8782
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16398363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant