Healthcare Provider Details

I. General information

NPI: 1437532132
Provider Name (Legal Business Name): CARRIE JO HAAR MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 S 4TH ST W
BAKER MT
59313-9156
US

IV. Provider business mailing address

171 VALLEY VIEW TRL PO BOX 438
BAKER MT
59313-9070
US

V. Phone/Fax

Practice location:
  • Phone: 406-778-2833
  • Fax: 406-778-5355
Mailing address:
  • Phone: 406-941-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR33400
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: