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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKSON EDGAR HAEN

Active Sole Proprietor

JACKSON EDGAR HAEN is a Nutritionist healthcare provider located in LARAMIE, Wyoming. NPI 1033806021 is currently active in the NPPES registry. Verify at CMS.

Nutritionist · LARAMIE, WY

Registration Details

NPI Number
1033806021
Provider Type
Individual
Gender
Male
NPI Issued
Apr 19, 2023 (3.1345810267196 yrs)
Last Updated
Apr 19, 2023
Sole Proprietor
Yes

Practice Information

Address
552 N PINE ST
LARAMIE, WY, 820722451
Browse WY providers · Browse ZIP 82072
Phone
7202564685
Primary Specialty
Nutritionist
133N00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.