Basic Information
| Provider Information | |||||||||
| NPI: | 1417266065 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAUENSTEIN | ||||||||
| FirstName: | NAARAH | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | |||||||||
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| Credential: | PA | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | HAUENSTEIN | ||||||||
| OtherFirstName: | NAARAH | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6950 E BELLEVIEW AVE | ||||||||
| Address2: | STE 300 | ||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801111618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037508100 | ||||||||
| FaxNumber: | 3039972116 | ||||||||
| Practice Location | |||||||||
| Address1: | 6950 E BELLEVIEW AVE | ||||||||
| Address2: | STE 300 | ||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801111618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037508100 | ||||||||
| FaxNumber: | 3039972116 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2010 | ||||||||
| LastUpdateDate: | 02/04/2015 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 085003848 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363L00000X | PA.0004043 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.