IndividualActive
Kristen Haacke
NPI 1679719215 · Critical Care Neonatal Nurse Practitioner · Salt Lake City, UT
Provider details
- NPI number
- 1679719215
- Entity type
- Individual
- Primary specialty
- Critical Care Neonatal Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 364477-4408 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
100 N Medical Dr
Salt Lake City, UT 84113-1103
Phone: (801) 662-4100
Approximate (ZIP-level) locationGet directions
Mailing address
100 N Medical Dr
Salt Lake City, UT 84113-1103
Registry dates
- Enumerated
- 2009-01-04
- Last updated
- 2021-09-08
- Certified
- 2021-09-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.