Jeffery David Haugen
Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in La Porte, IN. Individual provider (NPI-1).
NPI number1013502467
StatusActive
Last updated in NPPESJun 30, 2021
Details
- NPI
- 1013502467
- Entity type
- Individual (NPI-1)
- Name
- Jeffery David Haugen
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 8, 2021
- Certification date
- Jun 30, 2021
- Last updated
- Jun 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P0018X | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 26029234A | IN | Yes |
| 1835P0018X | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | CV2100518 | IN |
Practice location
55 Pine Lake AveLa Porte, IN 46350-3027
Phone 219-325-3152
Mailing address
55 Pine Lake AveLa Porte, IN 46350-3027
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