Provider Demographics
NPI:1225857550
Name:HAAS, MAKAYLA SKYLAR PAIGE (APRN)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:SKYLAR PAIGE
Last Name:HAAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 LANCASHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2940
Mailing Address - Country:US
Mailing Address - Phone:859-797-3629
Mailing Address - Fax:
Practice Address - Street 1:2104 LANCASHIRE AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2940
Practice Address - Country:US
Practice Address - Phone:859-797-3629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1165566163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse