Individual
STEPHANIE NICOLE HAUTSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-6900
(812) 355-6912
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003587A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/19/2021
Last updated
04/06/2022
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