| Doctor Name: | DR. LAURIE A NIELSEN-HAAK |
| NPI Number: | 1356346308 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | 36-00-3195-N |
| Business Practice Address: | 1013 E Spring St St Marys, OH - 458852447 |
| Business Phone Number: | 4193948664 |
| Business Fax Number: | 4193941148 |
| Mailing Address: | 1013 E Spring St, ST MARYS |
| State: | OH |
| Postal Code: | 458852447 |
| Phone Number: | 4193948664 |
| Fax Number: | 4193941148 |
| NPI Enumeration Date: | 06/16/2005 |
| NPI Last Update Date: | 12/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 36-00-3195-N |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |