Provider Demographics
NPI:1558790485
Name:HAAS, BRANDI LOVE (CRNP)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:LOVE
Last Name:HAAS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 SETON DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6149
Mailing Address - Country:US
Mailing Address - Phone:814-977-5287
Mailing Address - Fax:
Practice Address - Street 1:921 SETON DRIVE
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-2844
Practice Address - Country:US
Practice Address - Phone:301-724-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR124259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily