Provider Demographics
NPI:1740601608
Name:HAAS, JENNIFER ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:HAAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13861 PLANTATION RD
Mailing Address - Street 2:STE 104
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4342
Mailing Address - Country:US
Mailing Address - Phone:239-225-1306
Mailing Address - Fax:
Practice Address - Street 1:13861 PLANTATION RD
Practice Address - Street 2:STE 104
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4342
Practice Address - Country:US
Practice Address - Phone:239-225-1306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9378664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily