JOANNA KAE HAAG PMHNP NPI 1760052310

NPI Information

NPI: 1760052310
Provider Name: JOANNA KAE HAAG, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
6805 STATE ROUTE 162 STE 201
MARYVILLE, IL
ZIP 62062
Phone: (618) 288-5019
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Joanna Kae Haag, PMHNP is a psychiatric/mental health nurse practitioner in Maryville, IL with 3 years of experience. Joanna Kae Haag, PMHNP NPI is 1760052310. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6805 STATE ROUTE 162 STE 201
MARYVILLE, IL
ZIP 62062-530
Phone: (618) 288-5019

The NPI 1760052310 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/27/2021 and was last updated on 3/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	2021032483	MISSOURI	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	209027119	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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