Individual
JENNIFER R HAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
310 E COLLEGE DR, COLBY, KS 67701-3716
(785) 462-6184
(785) 460-1490
Mailing address
310 E COLLEGE DR, COLBY, KS 67701-3716
(785) 462-6184
(785) 460-1490
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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