Provider Demographics
NPI:1023381993
Name:HAUPT, ARA RUSTAD (PA-C)
Entity Type:Individual
Prefix:
First Name:ARA
Middle Name:RUSTAD
Last Name:HAUPT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ARA
Other - Middle Name:REGINA
Other - Last Name:RUSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2460 W 26TH AVE STE 420C
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5363
Mailing Address - Country:US
Mailing Address - Phone:303-688-0333
Mailing Address - Fax:303-688-0198
Practice Address - Street 1:2460 W 26TH AVE STE 420C
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5363
Practice Address - Country:US
Practice Address - Phone:303-688-0333
Practice Address - Fax:303-688-0198
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3312363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant