Provider Demographics
NPI:1114126190
Name:HAUSER, PENNY (CNM)
Entity Type:Individual
Prefix:MS
First Name:PENNY
Middle Name:
Last Name:HAUSER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:PENNY
Other - Middle Name:
Other - Last Name:SEUFFERLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:PO BOX 1638
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12201-1638
Mailing Address - Country:US
Mailing Address - Phone:207-777-4111
Mailing Address - Fax:207-783-6660
Practice Address - Street 1:330 SABATTUS STREET
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-777-4300
Practice Address - Fax:207-755-3021
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2011-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER037146367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife