Provider Demographics
NPI:1437629839
Name:HAUENSTEIN, MATTHEW E (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:E
Last Name:HAUENSTEIN
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9102
Mailing Address - Country:US
Mailing Address - Phone:937-642-1065
Mailing Address - Fax:937-642-3888
Practice Address - Street 1:1479 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9102
Practice Address - Country:US
Practice Address - Phone:937-642-1065
Practice Address - Fax:937-645-3888
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024417363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health