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General NPI Number Information
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NPI Number | 1235580978
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Entity Type | Individual
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Provider Name | JOHN HAUPERT PMHNP, MSN, RN
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Gender | Male
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 356 W 18TH ST
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City | NEW YORK
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State | NY
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Zip | 10011-4401
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Country | US
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Telephone | 212-271-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 630 DRAKE AVE
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City | SAUSALITO
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State | CA
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Zip | 94965-1107
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Country | US
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Telephone | 212-271-7200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95011629
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402019
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 715835
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License Number State | NY
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