Individual
CONSTANCE L WALL-HAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
126600
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
126600
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0359891
—
MA
01
—
NP9996
BLUE CROSS
MA
Enumeration date
03/08/2006
Last updated
03/10/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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