Provider Demographics
NPI:1811613805
Name:HAAS, ANNA GRACE (CNM)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:GRACE
Last Name:HAAS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11600 PUESTA DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-3580
Mailing Address - Country:US
Mailing Address - Phone:570-332-2149
Mailing Address - Fax:
Practice Address - Street 1:5819 N FM 88
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599-3275
Practice Address - Country:US
Practice Address - Phone:956-969-2538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036261367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife