Terry Haugen
Individual provider Active NPI Meals Provider · Etna, OH
NPI 1043986789 · NPPES record last updated Aug 23, 2021
Key facts
- NPI
- 1043986789
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Meals Provider 174200000X
- Practice address
- 122 Deer Path CT
Etna, OH 43062-6004 - Phone
- (614) 406-4627
- NPI assigned
- Aug 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lodging Provider | 177F00000X | |||
| Meals Provider | 174200000X | Yes |
Addresses
Primary practice location
122 Deer Path CT
Etna, OH 43062-6004
Mailing address
122 Deer Path CT
Etna, OH 43062-6004
Phone (614) 406-4627
Other providers in Etna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.