Provider Demographics
NPI:1023552478
Name:HAUSER, JORDAN (MS)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:
Last Name:HAUSER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 CHARLOTTE PARK DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-1956
Mailing Address - Country:US
Mailing Address - Phone:704-936-5567
Mailing Address - Fax:
Practice Address - Street 1:4651 CHARLOTTE PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1956
Practice Address - Country:US
Practice Address - Phone:704-936-5567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator