Provider Demographics
NPI:1275124463
Name:HAUGEN, KARISSA ANN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KARISSA
Middle Name:ANN
Last Name:HAUGEN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4891 MILLER TRUNK HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:HERMANTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55811-1563
Mailing Address - Country:US
Mailing Address - Phone:218-306-8383
Mailing Address - Fax:218-875-6315
Practice Address - Street 1:4891 MILLER TRUNK HWY STE 206
Practice Address - Street 2:
Practice Address - City:HERMANTOWN
Practice Address - State:MN
Practice Address - Zip Code:55811-1563
Practice Address - Country:US
Practice Address - Phone:218-310-8896
Practice Address - Fax:218-875-6315
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7999363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health