Provider Demographics
NPI:1205603750
Name:HASTE, TAMMY RENAE (MSN, APRN, NP-C)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENAE
Last Name:HASTE
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 GOVER ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-3332
Mailing Address - Country:US
Mailing Address - Phone:606-679-8331
Mailing Address - Fax:606-678-4427
Practice Address - Street 1:106 GOVER ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-3332
Practice Address - Country:US
Practice Address - Phone:606-679-8331
Practice Address - Fax:606-678-4427
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4012488363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner