Provider Demographics
NPI:1356020168
Name:MAAS, HAILIE NICOLE (PMHNP-BC DNP)
Entity type:Individual
Prefix:
First Name:HAILIE
Middle Name:NICOLE
Last Name:MAAS
Suffix:
Gender:F
Credentials:PMHNP-BC DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-6034
Mailing Address - Country:US
Mailing Address - Phone:406-461-6725
Mailing Address - Fax:
Practice Address - Street 1:400 CONLEY LAKE RD
Practice Address - Street 2:
Practice Address - City:DEER LODGE
Practice Address - State:MT
Practice Address - Zip Code:59722-8708
Practice Address - Country:US
Practice Address - Phone:406-415-6212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-217311363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health