Individual
TINA MARIE HAASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1513 PARK AVE FL 1, COLUMBUS, WI 53925-1793
(920) 623-9611
(920) 623-1788
Mailing address
1513 PARK AVE FL 1, COLUMBUS, WI 53925-1793
(920) 623-9611
(920) 623-1788
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10859
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811571912
—
WI
Enumeration date
05/06/2021
Last updated
03/08/2022
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