Healthcare Provider Details

I. General information

NPI: 1619658200
Provider Name (Legal Business Name): ADRIANA HASSELBRING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 FRANKLIN GTWY SE
MARIETTA GA
30067-8029
US

IV. Provider business mailing address

877 FRANKLIN GTWY SE
MARIETTA GA
30067-8029
US

V. Phone/Fax

Practice location:
  • Phone: 770-635-3301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number25598
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: