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General NPI Number Information
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NPI Number | 1922834266
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Entity Type | Individual
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Provider Name | HALEY NICOLE MASON CNP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 111 W 10TH AVE
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City | REDFIELD
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State | SD
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Zip | 57469-1519
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Country | US
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Telephone | 605-472-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 17634 SD HIGHWAY 37
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City | FRANKFORT
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State | SD
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Zip | 57440-7300
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Country | US
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Telephone | 605-280-3786
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | CP003363
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CP003363
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License Number State | SD
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