Brenda M Haugen, LICENSED SPECIALIST

Individual provider Active NPI Hearing Aid Equipment · Grand Forks, ND

NPI 1700933009 · NPPES record last updated Mar 25, 2010

Key facts

NPI
1700933009
Entity type
Individual (NPI type 1)
Primary specialty
Hearing Aid Equipment 332S00000X
License
2212 (MN)
Practice address
2812 17TH Ave S Ste E
Grand Forks, ND 58201-4048
Phone
(701) 746-8421
Fax
(701) 746-4719
NPI assigned
Jan 5, 2007
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
2212MNMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Aid Equipment 332S00000X 2212 MN Yes

Addresses

Primary practice location

2812 17TH Ave S Ste E
Grand Forks, ND 58201-4048

Mailing address

2812 17TH Ave S Ste E
Grand Forks, ND 58201-4048
Phone (701) 746-8421

Other providers in Grand Forks, ND

All providers in Grand Forks, ND · Hearing Aid Equipment in North Dakota

Sources for this page

Verify at the official NPI Registry.