Provider Demographics
NPI:1467717173
Name:HAUSER, KELLY ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:ANN
Last Name:HAUSER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1515
Mailing Address - Country:US
Mailing Address - Phone:585-813-3597
Mailing Address - Fax:
Practice Address - Street 1:43 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1515
Practice Address - Country:US
Practice Address - Phone:585-813-3597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY637635163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health