Provider Demographics
NPI:1922834266
Name:MASON, HALEY NICOLE (CNP)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:NICOLE
Last Name:MASON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17634 SD HIGHWAY 37
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:SD
Mailing Address - Zip Code:57440-7300
Mailing Address - Country:US
Mailing Address - Phone:605-280-3786
Mailing Address - Fax:
Practice Address - Street 1:111 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:REDFIELD
Practice Address - State:SD
Practice Address - Zip Code:57469-1519
Practice Address - Country:US
Practice Address - Phone:605-472-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP003363207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine