Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 0000058032 | TN |
NPI | 1144426669 |
---|---|
Provider Name | Dr. Alisa Renee Haushalter |
First Address | Nashville, TN 37216-2928 |
Second Address | Nashville, TN 37203-1503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2007 |
Last Update Date | 08/07/2007 |