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General NPI Number Information
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NPI Number | 1013904960
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Entity Type | Individual
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Provider Name | SUSAN HASSELLE MS, ARNP, CNS
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Gender | Female
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 900 MASSACHUSETTS ST
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City | LAWRENCE
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State | KS
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Zip | 66044-2868
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Country | US
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Telephone | 785-865-2400
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Fax | 785-865-0014
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Provider Business Mailing Address
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Address Line | 1571 N 962 RD
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City | LAWRENCE
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State | KS
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Zip | 66046-9224
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Country | US
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Telephone | 785-842-9138
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Fax | 785-865-0014
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 74031
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License Number State | KS
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