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NPI Code Detail

MEDICARE: JUSTINE WAI-WAI HAUNG

MEDICARE: JUSTINE WAI-WAI HAUNG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363AM0700XMedical Physician Assistant15695MN

General Provider Information

NPI Number : 1205795747
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTINE WAI-WAI HAUNG
Provider Business Mailing Address
First Line : 16715 STIRRUP LN
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55347-3390
Country : US
Telephone Number : 612-871-1145
Fax Number : 612-870-5491
Provider Business Practice Location Address
First Line : 1185 TOWN CENTRE DR STE 205
Second Line :
City : EAGAN
State : MN
Zip : 55123-1370
Country : US
Telephone Number : 612-871-1145
Fax Number : 612-870-5491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 04/02/2026

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Directions to “ JUSTINE WAI-WAI HAUNG ” Practice Location

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