Healthcare Provider Details

I. General information

NPI: 1114340007
Provider Name (Legal Business Name): SAMANTHA HAAS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2014
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD
MURFREESBORO TN
37129-1392
US

IV. Provider business mailing address

3400 LEBANON RD
MURFREESBORO TN
37129-1392
US

V. Phone/Fax

Practice location:
  • Phone: 615-225-3700
  • Fax:
Mailing address:
  • Phone: 615-225-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number150825
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18277
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: