Provider Demographics
NPI:1457330763
Name:HASSELLE, CHRISTINE C (MSN, CNS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
Last Name:HASSELLE
Suffix:
Gender:F
Credentials:MSN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 LENOX PARK BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-4299
Mailing Address - Country:US
Mailing Address - Phone:901-273-2368
Mailing Address - Fax:901-273-2351
Practice Address - Street 1:3150 LENOX PARK BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4299
Practice Address - Country:US
Practice Address - Phone:901-273-2368
Practice Address - Fax:901-273-2351
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000077973163WP0809X
TNAPN0000006298364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4031089OtherBCBS OF TENNESSEE
TN420001389OtherRAILROAD MEDICARE MPAC
TN3345715Medicaid
TN4031089OtherBCBS OF TENNESSEE
TN3345715Medicaid
TN3345716Medicare PIN