Provider Demographics
NPI:1083001218
Name:NESS, HALEY MARIE
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MARIE
Last Name:NESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37729 113TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHBY
Mailing Address - State:MN
Mailing Address - Zip Code:56309-4642
Mailing Address - Country:US
Mailing Address - Phone:218-770-4342
Mailing Address - Fax:
Practice Address - Street 1:37729 113TH ST
Practice Address - Street 2:
Practice Address - City:ASHBY
Practice Address - State:MN
Practice Address - Zip Code:56309-4642
Practice Address - Country:US
Practice Address - Phone:218-770-4342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-26
Last Update Date:2015-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer