MEDICARE: NICHOLE ELIZABETH HAEG PHARMD

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	1835P2201X	Ambulatory Care Pharmacist	26028927A	IN

General Provider Information

NPI Number	:	1730038456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE ELIZABETH HAEG PHARMD

Provider Business Mailing Address
First Line	:	575 RILEY HOSPITAL DR STE 4300
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5272
Country	:	US
Telephone Number	:	317-944-7010
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 RILEY HOSPITAL DR STE 4300
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5272
Country	:	US
Telephone Number	:	317-944-7010
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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