Provider Demographics
NPI:1740754530
Name:HAUGEN, LINDSAY S (APRN,CRNA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:S
Last Name:HAUGEN
Suffix:
Gender:F
Credentials:APRN,CRNA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:SOHOVICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CRNA
Mailing Address - Street 1:1702 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4940
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 E 3RD ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-1951
Practice Address - Country:US
Practice Address - Phone:218-786-8364
Practice Address - Fax:218-727-6889
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2473367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered