Provider Demographics
NPI:1437326022
Name:MAAS, MAYDRA ANN (CLINICAL NURSE SPECI)
Entity Type:Individual
Prefix:MS
First Name:MAYDRA
Middle Name:ANN
Last Name:MAAS
Suffix:
Gender:F
Credentials:CLINICAL NURSE SPECI
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:16659 200TH STREET
Mailing Address - Street 2:
Mailing Address - City:WALNUT GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:56180-4422
Mailing Address - Country:US
Mailing Address - Phone:507-742-2519
Mailing Address - Fax:
Practice Address - Street 1:120 FALLWOOD ROAD
Practice Address - Street 2:REDWOOD AREA HOSPITAL
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-1828
Practice Address - Country:US
Practice Address - Phone:508-747-2519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0832029364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health