Provider Demographics
NPI:1225062722
Name:HAUFF, ROSEMARY (PA-C)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:HAUFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7341 HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:LEHR
Mailing Address - State:ND
Mailing Address - Zip Code:58460-9111
Mailing Address - Country:US
Mailing Address - Phone:701-378-2315
Mailing Address - Fax:
Practice Address - Street 1:1015 4TH AVE S
Practice Address - Street 2:
Practice Address - City:WISHEK
Practice Address - State:ND
Practice Address - Zip Code:58495-0617
Practice Address - Country:US
Practice Address - Phone:701-452-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0034363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND01-23553OtherMEDICA @ GACKLE
ND12045OtherBSND @ KULM
ND2409700OtherAMERICA'S PPO
ND01-23360OtherMEDICA @ NAPOLEON
ND1008356OtherPREFERRED ONE
ND5166Medicaid
ND5085Medicaid
ND12569OtherBSND @ GACKLE
ND4652OtherBSND @ WISHEK
ND01-20601OtherMEDICA @ KULM
ND01-20602OtherMEDICA @ WISHEK
ND5028Medicaid
ND5063Medicaid
NDR02139Medicare UPIN
NDN4655Medicare ID - Type UnspecifiedMED B
ND5028Medicaid
ND353443Medicare ID - Type Unspecified@ GACKLE
ND4652OtherBSND @ WISHEK
ND1008356OtherPREFERRED ONE