| Doctor Name: | MRS. CYNTHIA L. HAACKE |
| NPI Number: | 1003803792 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | 2043174405 |
| Business Practice Address: | 20 W 1700 S Clearfield, UT - 840166004 |
| Business Phone Number: | 8014164474 |
| Business Fax Number: | |
| Mailing Address: | Po Box 27128, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841270128 |
| Phone Number: | 8013876150 |
| Fax Number: | |
| NPI Enumeration Date: | 09/29/2005 |
| NPI Last Update Date: | 10/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2043174405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |