Provider Demographics
NPI:1871747808
Name:HAAKENSON, CAROLINE PICONE (MD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:PICONE
Last Name:HAAKENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:PICONE
Other - Last Name:HENNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6565 FRANCE AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2141
Mailing Address - Country:US
Mailing Address - Phone:952-920-2200
Mailing Address - Fax:952-920-0866
Practice Address - Street 1:6565 FRANCE AVE S STE 200
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2141
Practice Address - Country:US
Practice Address - Phone:952-920-2200
Practice Address - Fax:952-920-0866
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN56889207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology