Provider Demographics
NPI:1508271784
Name:HAAS, HOLLY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:HAAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CARL RAMERT DR
Mailing Address - Street 2:
Mailing Address - City:YOAKUM
Mailing Address - State:TX
Mailing Address - Zip Code:77995-4868
Mailing Address - Country:US
Mailing Address - Phone:361-293-7061
Mailing Address - Fax:
Practice Address - Street 1:1200 CARL RAMERT DR
Practice Address - Street 2:
Practice Address - City:YOAKUM
Practice Address - State:TX
Practice Address - Zip Code:77995-4868
Practice Address - Country:US
Practice Address - Phone:361-293-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily