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NPI Code Detail

MEDICARE: DR. LAURIE A NIELSEN-HAAK DPM

MEDICARE: DR. LAURIE A NIELSEN-HAAK DPM
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
1213ES0103XFoot & Ankle Surgery Podiatrist36-00-3195-NOH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00248977OTHEROHMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356346308
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURIE A NIELSEN-HAAK DPM
Provider Business Mailing Address
First Line : 915 MICHIGAN ST STE 100
Second Line :
City : SIDNEY
State : OH
Zip : 45365-2401
Country : US
Telephone Number : 937-419-8049
Fax Number : 937-419-8050
Provider Business Practice Location Address
First Line : 915 MICHIGAN ST STE 100
Second Line :
City : SIDNEY
State : OH
Zip : 45365-2401
Country : US
Telephone Number : 937-419-8049
Fax Number : 937-419-8050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 07/13/2022

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