Provider Demographics
NPI:1659460541
Name:HAUGER, MONICA (NP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:HAUGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S STATE ROAD 135 STE C
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-8702
Mailing Address - Country:US
Mailing Address - Phone:317-878-4972
Mailing Address - Fax:317-878-4593
Practice Address - Street 1:106 S STATE ROAD 135 STE C
Practice Address - Street 2:
Practice Address - City:TRAFALGAR
Practice Address - State:IN
Practice Address - Zip Code:46181-8702
Practice Address - Country:US
Practice Address - Phone:317-878-4972
Practice Address - Fax:317-878-4593
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001295363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200495170Medicaid
IN151560UUUUMedicare PIN
IN151700TTMedicare PIN
IN151560UUUUMedicare PIN