MARY A HALLER (NPI# 1396769857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396769857 |
| Entity Type | Individual |
| Full Name | MARY A HALLER |
| Credential | PA |
| Practice Address |
1401 E H St Mc Cook NE 69001-3589 |
| Practice Telephone | 3083444110 |
| Practice Fax Number | 3083448369 |
| Mailing Telephone | 3083444110 |
| Mailing Fax Number | 3083448369 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2013-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 10210 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 02300010101 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
515 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487607230 | Mary C Haller | Internal Medicine | 500 Campus Dr, Hancock, MI 49930-1569 | 2006-05-19 |
| Street Address |
1401 E H ST |
| City | MC COOK |
| State | NE |
| Zip Code | 69001-3589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194797639 | Richard Klug | Family Medicine | 1401 E H St, Mc Cook, NE 69001-3432 | 2006-02-07 |
| 1477049922 | Ashley Marie Vontz | Family Medicine | 1401 E H St, Mc Cook, NE 69001-3589 | 2018-07-09 |
| 1356878243 | Naomi Elizabeth Olson | Nurse Practitioner | 1401 E H St, Mc Cook, NE 69001 | 2017-05-22 |
| 1598147845 | Matthew Nielsen | Family Medicine | 1401 E H St, Mc Cook, NE 69001 | 2015-06-23 |
| 1649542465 | Tasha L. Blomstedt | Physician Assistant | 1401 E H St, Mc Cook, NE 69001 | 2012-02-09 |
| 1649541376 | Alyssa B Bauer | Nurse Practitioner | 1401 E H St, Mc Cook, NE 69001-3589 | 2012-01-26 |
| 1033355367 | Lindsay Sue Taylor | Physician Assistant | 1401 E H St, Mc Cook, NE 69001-3589 | 2008-12-16 |
| 1174701239 | Kristin Marie Fulkerson | Family Medicine | 1401 E H St, Mc Cook, NE 69001-3589 | 2008-01-31 |
| 1154515245 | Victor Louis Stava | Physician Assistant | 1401 E H St, Mc Cook, NE 69001-3589 | 2007-08-31 |
| 1548351893 | Jason J Blomstedt | Family Medicine | 1401 E H St, Mc Cook, NE 69001-3589 | 2006-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750673059 | Diana Esther Euhus | Counselor | 1012 West 3rd, Mccook, NE 69001 | 2011-05-05 |
| 1154548394 | Don S Blank | Dentist | 811 Norris Avenue, Mccook, NE 69001 | 2007-04-19 |
| 1447315825 | Wellness Partners, LLC | Clinic/Center | 106 W. 3rd St., Mccook, NE 69001 | 2006-12-26 |
| 1720151574 | William L Graves Dds PC | Dentist | 411 West 5th Street, Mccook, NE 69001 | 2006-11-16 |
| 1235215666 | David Harold Smith | Pharmacist | Junction of Hwy 83 and Hwy 6-34, Mccook, NE 69001 | 2006-10-27 |
| 1104920339 | Mccook Pharmacy & Medical Supply | Pharmacist | 205 Norris Ave, Mccook, NE 69001 | 2006-09-08 |
| 1518999002 | Carrie M Roberts | Social Worker | 1012 West Third, Mccook, NE 69001 | 2006-07-07 |
| 1770586224 | Scott L Franssen | Orthopaedic Surgery | 1301 E H St, Mc Cook, NE 69001 | 2005-05-28 |
| 1497030548 | Paige Mauran Nielsen | Optometrist | 212 W 9th St, Mc Cook, NE 69001 | 2011-10-19 |
| 1902192545 | Region II Human Services | Community/Behavioral Health | 1012 West Third, Mccook, NE 69001 | 2011-06-22 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760454300 | Brett Schmitz | Physician Assistant | 2105 Norris Avenue, Brett A. Schmitz, Mc Cook, NE 69001-3432 | 2006-02-07 |
| 1538132899 | Charles J Krysl | Physician Assistant | 1401 E H St, Mc Cook, NE 69001-3432 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972919041 | Cherisa Anne Meyer-fletcher | Physician Assistant | 21317 Mcclellan Cir, Gretna, NE 68028-3962 | 2014-07-09 |
| 1558601450 | Shannon Nicole Buster | Physician Assistant | 3503 Samson Way Ste 108, Bellevue, NE 68123-4303 | 2013-03-01 |
| 1669745253 | Mary Maureen Garvin | Physician Assistant | Unmc Division of Endocrinology, 983020 Nebraska Medical Center, Omaha, NE 68198-3020 | 2012-02-14 |
| 1508198672 | Brian Barry Nice | Physician Assistant | 987424 Nebraska Medical Ctr, Omaha, NE 68198-7424 | 2010-02-01 |
| 1033340146 | Bluffs Health Care Clinic | Physician Assistant | 914 W 36th Str, Scottsbluff, NE 69361 | 2009-08-06 |
| 1639308893 | Lisa C Degen | Physician Assistant | 2116 W Faidley Ave Ste 400, Grand Island, NE 68803 | 2009-07-09 |
| 1528221520 | Andrea Christine Johnson | Physician Assistant | 10 East 31st Street, Kearney, NE 68847 | 2008-07-09 |
| 1407014723 | Kylie Michelle Hutsell | Physician Assistant | 11912 Elm St Ste 26, Omaha, NE 68144-4363 | 2008-05-23 |
| 1689849754 | Sarah C Minarick | Physician Assistant | 7100 Stephanie Lane, Ste #100, Lincoln, NE 68516-5332 | 2008-04-29 |
| 1093995342 | Jennifer Marie Moeller | Physician Assistant | 984120 Nebraska Medical Ctr, Omaha, NE 68198-4120 | 2007-11-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.