KRISTIN M HAUCK (NPI# 1083821441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083821441 |
| Entity Type | Individual |
| Full Name | KRISTIN M HAUCK |
| Credential | PA-C |
| Practice Address |
6130 Trier Rd Fort Wayne IN 46815-5378 |
| Mailing Address |
1234 E Dupont Rd Suite 1 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2604696603 |
| Practice Fax Number | 2609696037 |
| Mailing Telephone | 2604696603 |
| Mailing Fax Number | 2609693067 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2015-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10000759A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
10000759A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6130 TRIER RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-5378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184615841 | Joshua Daniel Kline | Family Medicine | 6130 Trier Rd, Fort Wayne, IN 46815-5378 | 2005-11-02 |
| 1801318639 | Emily Myers | Registered Nurse | 6130 Trier Rd, Fort Wayne, IN 46815-5378 | 2017-07-13 |
| 1467980573 | Brittany E Khan | Registered Nurse | 6130 Trier Rd, Fort Wayne, IN 46815-5378 | 2017-06-02 |
| 1851730147 | Emily Kathryn Miller | Nurse Practitioner | 6130 Trier Rd, Fort Wayne, IN 46815-5378 | 2013-06-19 |
| 1801916366 | Nicholas L Rico | Family Medicine | 6130 Trier Rd, Fort Wayne, IN 46815-5378 | 2007-03-29 |
| 1700991320 | Gerald Andrew Kelty | Family Medicine | 6130 Trier Rd, Fort Wayne, IN 46815-5339 | 2006-08-21 |
| 1497860167 | Paul Traianos Kaplanis | Family Medicine | 6130 Trier Rd, Fort Wayne, IN 46815-5339 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438944 | Erin R Griffin | Physician Assistant | 5621 Woodshire Dr Apt 5, Fort Wayne, IN 46835-2959 | 2020-08-22 |
| 1821608209 | Rebecca Coker | Physician Assistant | 5137 Truemper Way Apt 5, Fort Wayne, IN 46835-3252 | 2020-07-31 |
| 1114536844 | Amanda Kohl | Physician Assistant | 5429 River Run Trl # 5, Fort Wayne, IN 46825-6039 | 2020-07-29 |
| 1538778352 | Kiersten Michelle Coatney | Physician Assistant | 3924 Taylor Rd Apt 65, Fort Wayne, IN 46804-1945 | 2020-07-28 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1972890093 | Megan Bearman | Physician Assistant | 3640 New Vision Dr, Suite A, Fort Wayne, IN 46845-1717 | 2011-07-10 |
| 1114211729 | Joel A Ruetz | Physician Assistant | 7619 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2011-06-01 |
| 1568617256 | Parkview Health System Inc | Physician Assistant | 11104 Parkview Circle Dr Ste 320, Fort Wayne, IN 46845-1733 | 2008-11-21 |
| 1841441805 | Brooke B Kutka | Physician Assistant | 2512 East Dupont Rd, Suite 200, Fort Wayne, IN 46825-1609 | 2008-10-08 |
| 1265688808 | Kali E Veness | Physician Assistant | 2930 Lake Ave, Fort Wayne, IN 46805-5416 | 2008-08-14 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on KRISTIN M HAUCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.