Provider Demographics
NPI:1417266065
Name:HAUENSTEIN, NAARAH L (PA)
Entity Type:Individual
Prefix:
First Name:NAARAH
Middle Name:L
Last Name:HAUENSTEIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:NAARAH
Other - Middle Name:L
Other - Last Name:HAUENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6950 E BELLEVIEW AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1618
Mailing Address - Country:US
Mailing Address - Phone:303-750-8100
Mailing Address - Fax:303-997-2116
Practice Address - Street 1:6950 E BELLEVIEW AVE
Practice Address - Street 2:STE 300
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1618
Practice Address - Country:US
Practice Address - Phone:303-750-8100
Practice Address - Fax:303-997-2116
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003848363AM0700X
COPA.0004043363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214881Medicare Oscar/Certification