Individual provider Active NPI

Kristen Michele Haack, RN

  • Ambulatory Care Registered Nurse
  • Rochester, MN
National Provider Identifier
1104749514
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
1262193 Issued in MN
Practice address
3031 Rosemary LN NE
Rochester, MN 55906-4535
Phone
(507) 774-6630
NPI assigned
Aug 3, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP2201X 1262193 MN Primary

Addresses

Primary practice location

3031 Rosemary LN NE
Rochester, MN 55906-4535

Mailing address

3031 Rosemary LN NE
Rochester, MN 55906-4535
Phone (507) 774-6630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1104749514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 ROSEMARY LN NE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559064535",
            "telephone_number": "507-774-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 ROSEMARY LN NE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559064535",
            "telephone_number": "507-774-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAACK",
        "first_name": "KRISTEN",
        "middle_name": "MICHELE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MN",
            "license": "1262193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.