Provider Demographics
NPI:1558316349
Name:HAUENSTEIN, KAREN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:HAUENSTEIN
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 1:124 S FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-7105
Mailing Address - Country:US
Mailing Address - Phone:801-546-9441
Mailing Address - Fax:801-546-2422
Practice Address - Street 1:124 S FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-7105
Practice Address - Country:US
Practice Address - Phone:801-546-9441
Practice Address - Fax:801-546-2422
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT212991-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant