Individual
MS. JENNI M. HAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
933 E PIERCE ST, COUNCIL BLUFFS, IA 51503-4626
(712) 396-4360
(712) 396-7069
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1220
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100263273-00
—
NE
05
—
1316995343
—
IA
05
—
470687317-16
—
NE
Enumeration date
05/04/2006
Last updated
10/02/2018
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