Provider Demographics
NPI:1033782289
Name:HAUGHINBERRY, KATELYN CURRIN (NP)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:CURRIN
Last Name:HAUGHINBERRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 WILLOWDALE CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-3624
Mailing Address - Country:US
Mailing Address - Phone:757-287-5032
Mailing Address - Fax:
Practice Address - Street 1:8081 INNOVATION PARK DR # 700
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4867
Practice Address - Country:US
Practice Address - Phone:571-472-2900
Practice Address - Fax:571-472-2901
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182193363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health