Provider Demographics
NPI:1346875945
Name:HAAS, TANYA (DNP, MSN, RN)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:HAAS
Suffix:
Gender:F
Credentials:DNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10827 STACY RUN
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-8040
Mailing Address - Country:US
Mailing Address - Phone:540-903-5799
Mailing Address - Fax:
Practice Address - Street 1:10827 STACY RUN
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-8040
Practice Address - Country:US
Practice Address - Phone:540-903-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001148295163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse