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NPI Code Detail

MEDICARE: GAYLE ANN HACKBARTH FNP

MEDICARE: GAYLE ANN HACKBARTH FNP
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
1363LF0000XFamily Nurse Practitioner241342TX

General Provider Information

NPI Number : 1912196288
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAYLE ANN HACKBARTH FNP
Provider Business Mailing Address
First Line : 701 MCCLINTIC DR
Second Line :
City : GROESBECK
State : TX
Zip : 76642-2128
Country : US
Telephone Number : 254-729-3411
Fax Number : 254-729-3258
Provider Business Practice Location Address
First Line : 701 MCCLINTIC DR
Second Line :
City : GROESBECK
State : TX
Zip : 76642-2128
Country : US
Telephone Number : 254-729-3411
Fax Number : 254-729-3258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2007
Last Update Date : 09/17/2013

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Directions to “ GAYLE ANN HACKBARTH FNP” Practice Location

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