Provider Demographics
NPI:1790182848
Name:HAASE, MELANIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:HAASE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:5255 OFFICE PARK BLVD. APC PEDIATRICS
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-3443
Mailing Address - Country:US
Mailing Address - Phone:941-755-7000
Mailing Address - Fax:941-755-7088
Practice Address - Street 1:1862 RYE ROAD APC PEDIATRICS
Practice Address - Street 2:SUITE 101
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212
Practice Address - Country:US
Practice Address - Phone:941-755-7000
Practice Address - Fax:941-755-7088
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9309591363LF0000X
FLARNP9309591207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014308300Medicaid