Provider Demographics
NPI:1033806815
Name:MAAS, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MAAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 KNOLLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-3025
Mailing Address - Country:US
Mailing Address - Phone:309-251-2392
Mailing Address - Fax:
Practice Address - Street 1:502 N PROSPECT RD STE 18
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-7725
Practice Address - Country:US
Practice Address - Phone:309-251-2392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3422237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist