Provider Demographics
NPI:1447135256
Name:HAUGHTON, KADIANNE SIMONE (NP)
Entity type:Individual
Prefix:MRS
First Name:KADIANNE
Middle Name:SIMONE
Last Name:HAUGHTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 E 61ST ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5908
Mailing Address - Country:US
Mailing Address - Phone:347-200-1120
Mailing Address - Fax:
Practice Address - Street 1:2076 E 61ST ST FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5908
Practice Address - Country:US
Practice Address - Phone:347-200-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF357566-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily