Individual provider Active NPI

Katherine Hogan Haucke, MSN, RN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1720315310
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
774469 Issued in TX
Practice address
1935 Medical District Dr
Medical Affairs, Pavillion, 3Rd Floor
Dallas, TX 75235-7701
Phone
(214) 456-9287
NPI assigned
Nov 3, 2009
Last updated
May 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 774469 TX Primary

Addresses

Primary practice location

1935 Medical District Dr
Medical Affairs, Pavillion, 3Rd Floor
Dallas, TX 75235-7701

Mailing address

8510 Chadbourne Rd
Dallas, TX 75209-3414
Phone (214) 460-5194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
774469TXMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1720315310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 CHADBOURNE RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752093414",
            "telephone_number": "214-460-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "MEDICAL AFFAIRS, PAVILLION, 3RD FLOOR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUCKE",
        "first_name": "KATHERINE",
        "middle_name": "HOGAN",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-03",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "774469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.