Provider Demographics
NPI:1386628766
Name:HASSELL, JANET E (FNP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:E
Last Name:HASSELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 N. 12TH STREET
Mailing Address - Street 2:PO BOX 10700
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-5517
Mailing Address - Country:US
Mailing Address - Phone:970-255-1576
Mailing Address - Fax:970-254-2398
Practice Address - Street 1:3150 N 12TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-2863
Practice Address - Country:US
Practice Address - Phone:970-255-2576
Practice Address - Fax:970-254-2398
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO164990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01348622Medicaid
CO01348622Medicaid
COS06105Medicare UPIN