Healthcare Provider Details

I. General information

NPI: 1265336234
Provider Name (Legal Business Name): CHRISTINE HAAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 SUDER AVE
TOLEDO OH
43611-1418
US

IV. Provider business mailing address

5650 SUDER AVE
TOLEDO OH
43611-1418
US

V. Phone/Fax

Practice location:
  • Phone: 567-290-7664
  • Fax: 419-473-8295
Mailing address:
  • Phone: 567-290-7664
  • Fax: 419-473-8295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number337847
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: