Laura A Hafenstein, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3080 Issued in WI

Practice address

1504 Madison Ave
Fort Atkinson, WI 53538-3100

Phone

(920) 563-9357

NPI assigned

Jan 19, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1063127538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N4716 COUNTY ROAD G",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535519621",
            "telephone_number": "920-728-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383100",
            "telephone_number": "920-563-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFENSTEIN",
        "first_name": "LAURA",
        "middle_name": "A",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "3080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gruber, APNP
• Kayleigh Guertin, OTD
• Joseph Albert Guros, DDS
• Luella M Guzman, MD
• Arielle Kristine Hachtel, ATC
• Brittany Hagen, APSW
• Elizabeth J Hans
• Adelaide Hargarten
• Brooke Marie Hartwig, PA-C
• Chrisleigh Ann Olga Faleiro Hatch

• Athletic Trainer in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.