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
1	363A00000X	Physician Assistant

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	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16715 STIRRUP LN
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55347-3390
Country	:	US
Telephone Number	:	612-806-3703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ JUSTINE WAI-WAI HAUNG ” Practice Location

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