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General NPI Number Information
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NPI Number | 1972021343
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Entity Type | Individual
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Provider Name | NANCY HAUSTERMAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | BAYNE-JONES ARMY COMMUNITY HOSPITAL 1585 THIRD ST
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City | FORT POLK SOUTH
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State | LA
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Zip | 71459
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Country | US
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Telephone | 337-531-3922
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Fax |
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Provider Business Mailing Address
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Address Line | 1 JARRETT WHITE RD
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City | TRIPLER ARMY MEDICAL CENTER
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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