Provider Demographics
NPI:1215426531
Name:HAUPT, NATHAN LEE (CPNP-AC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:LEE
Last Name:HAUPT
Suffix:
Gender:M
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11709 HAMPTONBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6359
Mailing Address - Country:US
Mailing Address - Phone:972-261-3837
Mailing Address - Fax:
Practice Address - Street 1:7601 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3214
Practice Address - Country:US
Practice Address - Phone:469-303-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137418363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care