KRISTEN HAACKE (NPI# 1679719215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679719215 |
| Entity Type | Individual |
| Full Name | KRISTEN HAACKE |
| Practice Address |
100 N Medical Dr Salt Lake City UT 84113-1103 |
| Practice Telephone | 8016624100 |
| Mailing Telephone | 8016624100 |
| Enumeration Date | 2009-01-04 |
| Last Update Date | 2009-01-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
364477-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
364477-4408 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 N MEDICAL DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84113-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598763112 | Michael Wayne Boyer | Pediatrics | 100 N Medical Dr, Bmt, Salt Lake City, UT 84113-1103 | 2005-07-08 |
| 1508001736 | Juliann Wintch Allred | Psychiatry & Neurology | 100 N Medical Dr, Clinical Neurosciences Center, Neurology, Salt Lake City, UT 84132-0001 | 2008-12-02 |
| 1811141500 | Jennifer Grace O'donohoe | Student in an Organized Health Care Education/Training Program | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2008-11-08 |
| 1033362264 | Erin Kristin Zinkhan | Pediatrics | 100 N Medical Dr, Residency Office, Salt Lake City, UT 84113-1103 | 2008-10-31 |
| 1962652966 | Rachael D Rich | Nurse Practitioner | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2008-09-25 |
| 1528229101 | Julia Kelsey Gunther | Pediatrics | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2008-06-17 |
| 1225295520 | Primary Children's Medical Center | General Acute Care Hospital | 100 N Medical Dr, Primary Children's Medical Center Pediatric Cardiology, Salt Lake City, UT 84113-1103 | 2008-05-22 |
| 1942476569 | Pediatric Behavioral Health | Pediatrics | 100 N Medical Dr, Peds Behavioral Health, Salt Lake City, UT 84113-1103 | 2008-05-03 |
| 1871769471 | Machelle Ross Bateman | Nurse Practitioner | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2008-05-03 |
| 1023283736 | Debra Ann Templin | Nurse Practitioner | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2008-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
| 1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
| 1487945135 | Justin C Wheeler | Pediatrics | 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 | 2011-04-29 |
| 1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
| 1285959502 | Anna Katherine Eyre Ermarth | Pediatrics | 81 Mario Capecchi, Salt Lake City, UT 84113 | 2010-03-30 |
| 1457682072 | Elizabeth K Cho | Nurse Practitioner | 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 | 2010-01-21 |
| 1528290848 | Nancy Crandell Brown | Nurse Practitioner | 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 | 2009-08-20 |
| 1679708481 | Primary Children's Medical Center | General Acute Care Hospital | 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 | 2009-05-22 |
| 1467697235 | Tara Hook | Physical Therapist | 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 | 2008-12-09 |
| 1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
| Find all providers in zip 84113 | ||||
| Taxonomy Code | 363LN0005X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194242925 | Jeanette Louise Seidel | Nurse Practitioner | 50 N Medical Dr Bldg 525, Salt Lake City, UT 84132-0001 | 2017-08-23 |
| 1598313603 | Natalie Marie Collier | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2019-09-01 |
| 1386291649 | Anjeanette Newton | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2019-08-21 |
| 1952957607 | Allison Kendall | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2019-08-16 |
| 1861047334 | Elizabeth Anne Elliott | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2019-08-01 |
| 1528524030 | Jason Welch Egan | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2019-02-20 |
| 1649757089 | Krista Schulte | Nurse Practitioner | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2018-07-27 |
| 1366964140 | Kimberlee Brooks Chenoweth | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2017-07-12 |
| 1568907418 | Susan Sieg | Nurse Practitioner | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2017-01-02 |
| 1346616604 | Kendra Broussard | Nurse Practitioner | 50 N Medical Dr, Nicu, Salt Lake City, UT 84132-0001 | 2015-08-20 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84113 |
Please comment or provide details below to improve the information on KRISTEN HAACKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.