Provider Demographics
NPI:1619289550
Name:HAUSER, CINDY DEMENGE (APRN, CNP, CNNP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:DEMENGE
Last Name:HAUSER
Suffix:
Gender:F
Credentials:APRN, CNP, CNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BUNKER HILL DR
Mailing Address - Street 2:RIVERWOOD HEALTHCARE CENTER
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431-1865
Mailing Address - Country:US
Mailing Address - Phone:218-927-2157
Mailing Address - Fax:218-927-4130
Practice Address - Street 1:200 BUNKER HILL DR
Practice Address - Street 2:RIVERWOOD HEALTHCARE CENTER
Practice Address - City:AITKIN
Practice Address - State:MN
Practice Address - Zip Code:56431-1865
Practice Address - Country:US
Practice Address - Phone:218-927-2157
Practice Address - Fax:218-927-4130
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1222476363L00000X
MNR122247-6363L00000X, 363LF0000X
MNAPRN-CNP0871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1619289550Medicaid
MNP00881523OtherRAILROAD MEDICARE
MN500006034Medicare PIN