MEDICARE: TRESSICA HASBARGEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	08-1004	NV

General Provider Information

NPI Number	:	1578759890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRESSICA HASBARGEN

Provider Business Mailing Address
First Line	:	P.O BOX 364
Second Line	:
City	:	GLYNDON
State	:	MN
Zip	:	56547
Country	:	US
Telephone Number	:	701-238-9235
Fax Number	:

Provider Business Practice Location Address
First Line	:	7405 BURNHAM AVE
Second Line	:	# 2014-3
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1571
Country	:	US
Telephone Number	:	701-238-9235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	09/20/2007

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Directions to “ TRESSICA HASBARGEN ” Practice Location

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