Provider Demographics
NPI:1124867171
Name:HAAS, JENILEE LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:JENILEE
Middle Name:LYNN
Last Name:HAAS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 FARM HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:JAMES CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:16657-8636
Mailing Address - Country:US
Mailing Address - Phone:814-386-1334
Mailing Address - Fax:
Practice Address - Street 1:1225 WARM SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2350
Practice Address - Country:US
Practice Address - Phone:814-643-7098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN579863163WP0808X
PASP029797363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health