NPI 1033806021

Jackson Edgar Haen

Practitioner Nutritionist Laramie, WY

Practice location

Address: 552 N Pine St, Laramie, WY 82072-2451
Phone: (720) 256-4685

Registered specialties

Nutritionist Primary

Dietary & Nutritional Service Providers Taxonomy 133N00000X

Other Nutritionist providers in Wyoming →

Registry record

NPI: 1033806021
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Apr 2023
Record last updated: 19 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.