Provider Demographics
NPI:1275597007
Name:HAASE, JAMES STEPHEN (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STEPHEN
Last Name:HAASE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1407
Mailing Address - Country:US
Mailing Address - Phone:785-842-7026
Mailing Address - Fax:785-842-7088
Practice Address - Street 1:613 N 2ND ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1407
Practice Address - Country:US
Practice Address - Phone:785-842-7026
Practice Address - Fax:785-842-7088
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2018-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS54238367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered