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Individual
JENNIFER R HAAG
Active
Individual
JENNIFER R HAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01388
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-01388
KANSAS LICENSE
KS
05
—
200671470A
—
KS
Enumeration date
08/09/2010
Last updated
02/27/2015
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