KELLY HAUSENBAUER P.A. NPI 1053695304

NPI Information

NPI: 1053695304
Provider Name: KELLY HAUSENBAUER, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
310 W NINTH ST
FREDERICK, MD
ZIP 21701
Phone: (301) 695-6800
Get Directions

Kelly Hausenbauer, P.A. is a medical physician assistant in Frederick, MD with 13 years of experience. Kelly Hausenbauer, P.A. NPI is 1053695304. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

310 W NINTH ST
FREDERICK, MD
ZIP 21701-546
Phone: (301) 695-6800
Fax: (301) 695-6891

The NPI 1053695304 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/5/2011 and was last updated on 10/5/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	C0004612	MARYLAND	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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