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General NPI Number Information
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NPI Number | 1366544850
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Entity Type | Individual
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Provider Name | NANCY HAAS CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/04/2006
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 1425 MALABAR RD NE
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City | PALM BAY
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State | FL
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Zip | 32907-2506
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Country | US
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Telephone | 321-434-8025
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Fax | 321-434-8075
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Provider Business Mailing Address
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Address Line | PO BOX 561600
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City | ROCKLEDGE
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State | FL
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Zip | 32956-1600
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Country | US
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Telephone | 321-434-4600
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Fax | 321-259-0635
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP9176721
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License Number State | FL
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