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NPI Code Detail

MEDICARE: MS. ERIN NICOLE JACKSON HAUGEN PHD

MEDICARE: MS. ERIN NICOLE JACKSON HAUGEN PHD
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
1103TC0700XClinical Psychologist402ND

General Provider Information

NPI Number : 1528276458
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIN NICOLE JACKSON HAUGEN PHD
Provider Business Mailing Address
First Line : 3535 S 31ST ST STE 201
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-3593
Country : US
Telephone Number : 701-780-6821
Fax Number : 701-780-1973
Provider Business Practice Location Address
First Line : 3535 S 31ST ST STE 201
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-3593
Country : US
Telephone Number : 701-780-6821
Fax Number : 701-780-1973
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 12/15/2025

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Directions to “ MS. ERIN NICOLE JACKSON HAUGEN PHD” Practice Location

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