Individual
NICHOLE LEA HAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 4TH AVE NORTH, FERGUS FALLS, MN 56537-1034
(218) 998-3778
(218) 998-3187
Mailing address
207 W. HARVEY, ELY, MN 55741
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
466358-6
MN
Other
Enumeration date
12/02/2008
Last updated
12/02/2008
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