Provider Demographics
NPI:1710227574
Name:HAUGE, TWILA KAY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TWILA
Middle Name:KAY
Last Name:HAUGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 MAIN ST S
Mailing Address - Street 2:#1
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-2587
Mailing Address - Country:US
Mailing Address - Phone:320-587-5162
Mailing Address - Fax:
Practice Address - Street 1:246 MAIN ST S
Practice Address - Street 2:#1
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-2587
Practice Address - Country:US
Practice Address - Phone:320-587-5162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL61571-2164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse