Healthcare Provider Details

I. General information

NPI: 1720042484
Provider Name (Legal Business Name): REBECCA SUE HASMANN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 E 3RD ST
SILER CITY NC
27344-2728
US

IV. Provider business mailing address

7012 JOHNSON MILL RD
BAHAMA NC
27503-9689
US

V. Phone/Fax

Practice location:
  • Phone: 919-799-2191
  • Fax: 919-799-2427
Mailing address:
  • Phone: 919-308-5895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200707
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: