Provider Demographics
NPI:1104808708
Name:HAUPT, MARGARET M (FNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:HAUPT
Suffix:
Gender:F
Credentials:FNP
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 1520
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3213
Mailing Address - Country:US
Mailing Address - Phone:541-296-9151
Mailing Address - Fax:541-296-9156
Practice Address - Street 1:551 LONE PINE BLVD
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-1520
Practice Address - Country:US
Practice Address - Phone:541-506-6920
Practice Address - Fax:541-296-5451
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR90006900RN363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR218103Medicaid
OR218112Medicaid
OR113980Medicaid
ORR131229Medicare PIN
OR113980Medicaid
OR383996Medicare Oscar/Certification
OR383994Medicare Oscar/Certification