Provider Demographics
NPI:1053389577
Name:HAUER, KAREN (OTR)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:HAUER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:TANGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BOX 871
Mailing Address - Street 2:CMR 470
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09165
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:EDIS
Practice Address - Street 2:CMR 470
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09165
Practice Address - Country:US
Practice Address - Phone:314-322-8213
Practice Address - Fax:314-322-8887
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8153171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider