Provider Demographics
NPI:1912009663
Name:HAUSTEEN, KAREN GRACE (RNFA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:GRACE
Last Name:HAUSTEEN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22212
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-0212
Mailing Address - Country:US
Mailing Address - Phone:760-898-6641
Mailing Address - Fax:
Practice Address - Street 1:13252 N 38TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-6608
Practice Address - Country:US
Practice Address - Phone:602-441-0250
Practice Address - Fax:602-441-0250
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN031338163WR0006X
CA250417163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN031338OtherRN
CA250417OtherRN