Healthcare Provider Details

I. General information

NPI: 1558600676
Provider Name (Legal Business Name): JANINE M HASS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2013
Last Update Date: 02/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 DEL PRADO BLVD #7
CAPE CORAL FL
33990-2676
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-3492
  • Fax: 239-424-4030
Mailing address:
  • Phone: 239-424-1400
  • Fax: 239-424-1421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9354055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: