Doctor Name: | MRS. SUSAN HASSELLE |
NPI Number: | 1013904960 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, ARNP, CNS |
License Number: | 74031 |
Business Practice Address: | 900 Massachusetts St Lawrence, KS - 660442868 |
Business Phone Number: | 7858652400 |
Business Fax Number: | 7858650014 |
Mailing Address: | 1571 N 962 Rd, LAWRENCE |
State: | KS |
Postal Code: | 660469224 |
Phone Number: | 7858429138 |
Fax Number: | 7858650014 |
NPI Enumeration Date: | 10/04/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0808X |
License Number: | 74031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |