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Individual

MS. KATHRYN ANN HAACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP - FNP-C

Contact information

Practice address
2720 STONE PARK BLVD, SUITE 110, SIOUX CITY, IA 51102
(712) 239-4702
(712) 239-0616
Mailing address
P.O. BOX 3128, SIOUX CITY, IA 51102
(712) 239-4702
(712) 239-0616

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A-055923
IA
363L00000X
Nurse Practitioner
Primary
A055923
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0092080
IA
Enumeration date
10/16/2006
Last updated
07/06/2011
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