Individual
EILEEN JOHANNA HAEG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
112 ABBEY RD, COLLEGEVILLE, MN 56321-7777
(320) 263-3124
(320) 363-3124
Mailing address
112 ABBEY RD, COLLEGEVILLE, MN 56321-7777
(320) 263-3142
(320) 363-3124
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MN9262
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0115114
MEDICA
MN
05
—
7926656100
—
MN
01
—
83A20HA
BCBS PROVIDER NUMBER
MN
01
—
989631015831
PREFERRED ONE
MN
01
—
HP26988
HEALTH PARTNERS
MN
Enumeration date
06/23/2005
Last updated
07/08/2007
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