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General NPI Number Information
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NPI Number | 1437629839
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Entity Type | Individual
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Provider Name | MATTHEW E HAUENSTEIN DNP, APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 211 STOCKSDALE DR
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City | MARYSVILLE
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State | OH
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Zip | 43040-5507
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Country | US
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Telephone | 380-285-1288
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Fax | 937-806-4104
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Provider Business Mailing Address
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Address Line | 211 STOCKSDALE DR
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City | MARYSVILLE
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State | OH
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Zip | 43040-5507
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Country | US
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Telephone | 380-285-1288
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Fax | 937-806-4104
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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 | APRN.CNP.024417
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License Number State | OH
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