Doctor Name: | GAYLE ANN HACKBARTH |
NPI Number: | 1912196288 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 241342 |
Business Practice Address: | 701 Mcclintic Dr Groesbeck, TX - 766422128 |
Business Phone Number: | 2547293411 |
Business Fax Number: | 2547293258 |
Mailing Address: | 701 Mcclintic Dr, GROESBECK |
State: | TX |
Postal Code: | 766422128 |
Phone Number: | 2547293411 |
Fax Number: | 2547293258 |
NPI Enumeration Date: | 10/23/2007 |
NPI Last Update Date: | 09/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 241342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |