Provider Demographics
NPI:1962727503
Name:HAEUSSNER, GINA LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:LEIGH
Last Name:HAEUSSNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:LEIGH
Other - Last Name:SCHIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2329 W MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8200
Mailing Address - Country:US
Mailing Address - Phone:720-532-1856
Mailing Address - Fax:609-222-8401
Practice Address - Street 1:2329 W MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8200
Practice Address - Country:US
Practice Address - Phone:720-532-1856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0053706207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO52971511Medicaid