Provider Demographics
NPI:1568730968
Name:HAUSMANN, KATHERINE (CO)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HAUSMANN
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 BILLINGSLEY ROAD, #104
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1046
Mailing Address - Country:US
Mailing Address - Phone:704-377-7099
Mailing Address - Fax:704-377-7983
Practice Address - Street 1:411 BILLINGSLEY RD STE 104
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1066
Practice Address - Country:US
Practice Address - Phone:704-377-7099
Practice Address - Fax:704-377-7983
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCO005012222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist