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General NPI Number Information
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NPI Number | 1972119014
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Entity Type | Individual
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Provider Name | MICHAEL CHRISTOPHER HASSERT MSN, APN, AGNP-C
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Gender | Male
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 6637 BERTHOLD AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-3318
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Country | US
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Telephone | 573-247-9982
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735378
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City | CHICAGO
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State | IL
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Zip | 60673-5378
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Country | US
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Telephone |
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 2023007556
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2023007556
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License Number State | MO
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