1114170875 NPI number — MS. PATRICIA CHRISTINE HASEN FNP-BC

Table of content: MS. PATRICIA CHRISTINE HASEN FNP-BC (NPI 1114170875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114170875 NPI number — MS. PATRICIA CHRISTINE HASEN FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HASEN
Provider First Name:
PATRICIA
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114170875
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 555191
Provider Second Line Business Mailing Address:
31 AREA BRANCH MEDICAL CLINIC
Provider Business Mailing Address City Name:
CAMP PENDLETON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92055-5191
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-725-7135
Provider Business Mailing Address Fax Number:
760-725-6668

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31 AREA BRANCH MEDICAL CLINIC
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055-5191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-7135
Provider Business Practice Location Address Fax Number:
760-725-6668
Provider Enumeration Date:
10/28/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  500989 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 364SE0003X , with the licence number: 500989 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)