Provider Demographics
NPI:1396791851
Name:HOUGLAND, KRISTEN TAFT (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:TAFT
Last Name:HOUGLAND
Suffix:
Gender:F
Credentials:MD
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 737
Mailing Address - Street 2:
Mailing Address - City:HAWLEYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06440-0737
Mailing Address - Country:US
Mailing Address - Phone:626-755-0791
Mailing Address - Fax:
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-6940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA927142080N0001X
IN01072126A2080N0001X
CT548092080N0001X
HI189252080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201188110Medicaid
IN000000924928OtherBCBS MFM