Healthcare Provider Details

I. General information

NPI: 1396162343
Provider Name (Legal Business Name): KAREN HASSELL FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4154 W VIENNA RD
CLIO MI
48420-2809
US

IV. Provider business mailing address

4154 W VIENNA RD
CLIO MI
48420-2809
US

V. Phone/Fax

Practice location:
  • Phone: 810-406-4246
  • Fax:
Mailing address:
  • Phone: 810-406-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704215196
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704215196
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: