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General NPI Number Information
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NPI Number | 1578759890
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Entity Type | Individual
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Provider Name | TRESSICA HASBARGEN
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Gender | Female
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 7405 BURNHAM AVE # 2014-3
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City | LAS VEGAS
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State | NV
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Zip | 89123-1571
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Country | US
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Telephone | 701-238-9235
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Fax |
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Provider Business Mailing Address
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Address Line | P.O BOX 364
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City | GLYNDON
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State | MN
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Zip | 56547
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Country | US
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Telephone | 701-238-9235
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 08-1004
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License Number State | NV
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