person
Cody Haas, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner in Chubbuck, Idaho
NPI 1902462039

Cody Haas is a Psychiatric/Mental Health Nurse Practitioner based in Pocatello, ID and is specialized in Psychiatric/Mental Health. Cody Haas practices in Chubbuck, ID and has the professional credentials of PMHNP-BC. The NPI Number for Cody Haas is 1902462039 and holds a License No. 58483 (Idaho).

The current practice location address for Cody Haas is 4650 Hawthorne Rd Ste 3B, Chubbuck, ID and can be reached out via phone at 208-252-5621 and via fax at 208-648-4167.

Location: 4650 Hawthorne Rd Ste 3B, Chubbuck, ID, 83206-2516
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Provider Profile Details
NPI Number
1902462039
Provider Name
Cody Haas
Credential
PMHNP-BC
Provider Entity Type
Individual
Gender
Male
Address
4650 Hawthorne Rd Ste 3B, Chubbuck, ID, 83206-2516
Phone Number
208-252-5621
Fax Number
208-648-4167
Provider Enumeration Date
05/14/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1902462039 05 ID
500808652 05 OR
institution
Provider Business Practice Location Address Details
Address
4650 Hawthorne Rd Ste 3B
City
State
Zip
83202-2376
Phone Number
208-252-5621
Fax Number
208-648-4167
person
Provider Business Mailing Address Details
Address
4650 Hawthorne Rd Ste 3B
City
State
Zip
83202-2376
Phone Number
208-252-5621
Fax Number
208-648-4167
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
58483 (Idaho)
Definition
Definition to come...
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