MEDICARE: CHRISTINE C HASSELLE MSN, CNS

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	RN0000077973	TN
2	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	APN0000006298	TN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	420001389	OTHER	TN	RAILROAD MEDICARE MPAC

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4031089	OTHER	TN	BCBS OF TENNESSEE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1457330763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE C HASSELLE MSN, CNS

Provider Business Mailing Address
First Line	:	3150 LENOX PARK BLVD
Second Line	:	SUITE 214
City	:	MEMPHIS
State	:	TN
Zip	:	38115-4299
Country	:	US
Telephone Number	:	901-273-2368
Fax Number	:	901-273-2351

Provider Business Practice Location Address
First Line	:	3150 LENOX PARK BLVD
Second Line	:	SUITE 214
City	:	MEMPHIS
State	:	TN
Zip	:	38115-4299
Country	:	US
Telephone Number	:	901-273-2368
Fax Number	:	901-273-2351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	04/13/2011

3150 LENOX PARK BLVD , STE 214
MEMPHIS, TN
38115-4299

Practice Phone: 901-273-2372
Practice Fax: 901-273-2351