Provider Demographics
NPI:1518210533
Name:HAASE, MEREDITH (FNP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:HAASE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 LOUGHBORO RD NE
Mailing Address - Street 2:
Mailing Address - City:WASHUNGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4630
Mailing Address - Country:US
Mailing Address - Phone:202-660-7510
Mailing Address - Fax:
Practice Address - Street 1:8505 ARLINGTON BLVD
Practice Address - Street 2:320
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4630
Practice Address - Country:US
Practice Address - Phone:703-641-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC363LP2300X363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care