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General NPI Number Information
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NPI Number | 1851891147
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Entity Type | Individual
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Provider Name | KATHLEEN ANN HASSEMER
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Gender | Female
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 02/14/2018
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Provider Practice Location Address
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Address Line | 2116 CRAIG RD
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6149
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Country | US
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Telephone | 715-858-4747
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Fax |
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Provider Business Mailing Address
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Address Line | 1265 SCOTT DR
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City | MINNETRISTA
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State | MN
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Zip | 55364-8247
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Country | US
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Telephone | 715-563-3784
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1378-39
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License Number State | WI
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