1144982646 NPI number — ANA RITA HAUGE FNP

Table of content: ANA RITA HAUGE FNP (NPI 1144982646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144982646 NPI number — ANA RITA HAUGE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAUGE
Provider First Name:
ANA
Provider Middle Name:
RITA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144982646
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COMPREHENSIVE PRIMARY CARE, LLC
Provider Second Line Business Mailing Address:
3905 JOHNS CREEK COURT, SUITE 200
Provider Business Mailing Address City Name:
SUWANEE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30024-1225
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-888-2273
Provider Business Mailing Address Fax Number:
678-888-2200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COMPREHENSIVE PRIMARY CARE, LLC
Provider Second Line Business Practice Location Address:
761 WALTHER ROAD, SUITE 200
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-888-2273
Provider Business Practice Location Address Fax Number:
678-888-2200
Provider Enumeration Date:
10/12/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  RN243738 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)