Provider Demographics
NPI:1720567514
Name:HAUBACH, KIRA T (NP-C)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:T
Last Name:HAUBACH
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Gender:F
Credentials:NP-C
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Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-983-3127
Mailing Address - Fax:765-983-3219
Practice Address - Street 1:1100 REID PKWY STE 210
Practice Address - Street 2:RICHMOND CARDIOLOGY ASSOCIATES
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374
Practice Address - Country:US
Practice Address - Phone:765-962-1337
Practice Address - Fax:765-966-0858
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2021-05-14
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Provider Licenses
StateLicense IDTaxonomies
IN71008158A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71008158AOtherFAMILY NURSE PRACTITIONER