Individual
CHASIE L. HAUPT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1295 JACARANDA BLVD, VENICE, FL 34292-4522
(941) 538-7947
(941) 484-1072
Mailing address
5220 SUMMERLIN COMMONS BLVD FL 4, FORT MYERS, FL 33907-2149
(239) 232-1180
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9101528
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291046200
—
FL
01
—
970021281
RAILROAD MEDICARE
—
01
—
970021284
RAILROAD MEDICARE
—
01
—
E5925V
PTAN
FL
Enumeration date
04/14/2006
Last updated
01/08/2024
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