Provider Demographics
NPI:1194399873
Name:MASON, HAILEIGH (APRN)
Entity Type:Individual
Prefix:MS
First Name:HAILEIGH
Middle Name:
Last Name:MASON
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 1:2835 W 2400 N
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84404-8599
Mailing Address - Country:US
Mailing Address - Phone:801-529-7005
Mailing Address - Fax:
Practice Address - Street 1:1893 E SKYLINE DR # 104
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-5218
Practice Address - Country:US
Practice Address - Phone:801-529-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT92487884405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner