1225559321 NPI number — ABIGAIL JEAN HAAG DAVIS DNP

Table of content: ABIGAIL JEAN HAAG DAVIS DNP (NPI 1225559321)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225559321 NPI number — ABIGAIL JEAN HAAG DAVIS DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIS
Provider First Name:
ABIGAIL
Provider Middle Name:
JEAN HAAG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225559321
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
N50W15735 MAPLE CREST LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MENOMONEE FALLS
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53051-6643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-712-0362
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
W165N5595 CREEKWOOD XING
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MENOMONEE FALLS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53051-0685
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-252-1050
Provider Business Practice Location Address Fax Number:
262-252-4781
Provider Enumeration Date:
06/29/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  7733 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100070145 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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