Provider Demographics
NPI:1356484448
Name:HAUGEN, RONALD JAY (CNP)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAY
Last Name:HAUGEN
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1199
Mailing Address - Country:US
Mailing Address - Phone:575-748-3333
Mailing Address - Fax:575-541-3495
Practice Address - Street 1:1410 N 8TH ST STE C
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3217
Practice Address - Country:US
Practice Address - Phone:575-725-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR59798363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health