Provider Demographics
NPI:1861807935
Name:HAAS, MICHELLE JANET (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JANET
Last Name:HAAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31410 CARLTON DR
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-1435
Mailing Address - Country:US
Mailing Address - Phone:216-990-3593
Mailing Address - Fax:
Practice Address - Street 1:31410 CARLTON DR
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-1435
Practice Address - Country:US
Practice Address - Phone:216-990-3593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385654163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health