Provider Demographics
NPI:1720315310
Name:HAUCKE, KATHERINE HOGAN (MSN, RN, CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:HOGAN
Last Name:HAUCKE
Suffix:
Gender:F
Credentials:MSN, RN, CPNP-PC
Other - Prefix:
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Mailing Address - Street 1:8510 CHADBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-3414
Mailing Address - Country:US
Mailing Address - Phone:214-460-5194
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:MEDICAL AFFAIRS, PAVILLION, 3RD FLOOR
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-9287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX774469363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics