MEDICARE: KRISTIN HAUGAN M.D.

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	207Q00000X	Family Medicine Physician	35405	MN

General Provider Information

NPI Number	:	1548235443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN HAUGAN M.D.

Provider Business Mailing Address
First Line	:	7701 YORK AVE S
Second Line	:	STE 300
City	:	EDINA
State	:	MN
Zip	:	55435-5864
Country	:	US
Telephone Number	:	952-926-6489
Fax Number	:	952-926-6501

Provider Business Practice Location Address
First Line	:	6363 FRANCE AVE S
Second Line	:	SUITE 525
City	:	EDINA
State	:	MN
Zip	:	55435-2129
Country	:	US
Telephone Number	:	952-926-6489
Fax Number	:	952-915-5261

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	09/30/2016

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