Doctor Name: | MS. HEATHER ELIZABETH HASENMYER |
NPI Number: | 1558751628 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 2429 |
Business Practice Address: | 400 Oak Street Taft, OK - 744630315 |
Business Phone Number: | 9186838365 |
Business Fax Number: | 9186867201 |
Mailing Address: | 400 Oak Street, TAFT |
State: | OK |
Postal Code: | 744630315 |
Phone Number: | 9186838365 |
Fax Number: | 9186867201 |
NPI Enumeration Date: | 01/28/2015 |
NPI Last Update Date: | 01/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 2429 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |