Provider Demographics
NPI:1831488188
Name:HAAR, MARYANNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARYANNE
Middle Name:
Last Name:HAAR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MARYANNE
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:321 DOUGLAS DR
Mailing Address - Street 2:321 DOUGLAS DRIVE
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-1305
Mailing Address - Country:US
Mailing Address - Phone:419-217-5127
Mailing Address - Fax:
Practice Address - Street 1:321 DOUGLAS DR
Practice Address - Street 2:321 DOUGLAS DRIVE
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-1305
Practice Address - Country:US
Practice Address - Phone:419-217-5127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN097393164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse