MEDICARE: KAREN HAAG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse	28186455A	IN

General Provider Information

NPI Number	:	1356099972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN HAAG

Provider Business Mailing Address
First Line	:	6120 GRAYSFORD PLACE
Second Line	:	SUITE 101
City	:	FORT WAYNE
State	:	IN
Zip	:	46835
Country	:	US
Telephone Number	:	260-450-0241
Fax Number	:	888-838-0232

Provider Business Practice Location Address
First Line	:	6120 GRAYSFORD PLACE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-4683
Country	:	US
Telephone Number	:	260-417-4535
Fax Number	:	888-838-0232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2022
Last Update Date	:	03/14/2022

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Directions to “ KAREN HAAG ” Practice Location

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