Provider Demographics
NPI:1023099884
Name:HAUPT, JUDITH H (RNC)
Entity type:Individual
Prefix:MISS
First Name:JUDITH
Middle Name:H
Last Name:HAUPT
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8 BURNHAM ST
Mailing Address - Street 2:
Mailing Address - City:TURNERS FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01376-1816
Mailing Address - Country:US
Mailing Address - Phone:413-774-3751
Mailing Address - Fax:413-775-9137
Practice Address - Street 1:8 BURNHAM ST
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1816
Practice Address - Country:US
Practice Address - Phone:413-774-3751
Practice Address - Fax:413-775-9137
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA153467363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9758038Medicaid
MAPI2257Medicare UPIN
MA9758038Medicaid