Provider Demographics
NPI:1184824781
Name:HASHIM, MERRIOM LASAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MERRIOM
Middle Name:LASAN
Last Name:HASHIM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 THAMES PL
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-7167
Mailing Address - Country:US
Mailing Address - Phone:706-560-1179
Mailing Address - Fax:
Practice Address - Street 1:3335 THAMES PL
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-7167
Practice Address - Country:US
Practice Address - Phone:706-560-1179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 174749163W00000X
SCR 105501163W00000X
VA0001182357163W00000X
GARN174749163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse