Provider Demographics
NPI:1619938461
Name:HASSELBECK, ANNETTE NOEL (CRNA)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:NOEL
Last Name:HASSELBECK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-9764
Mailing Address - Country:US
Mailing Address - Phone:716-741-3076
Mailing Address - Fax:
Practice Address - Street 1:6011 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:CLARENCE CENTER
Practice Address - State:NY
Practice Address - Zip Code:14032-9764
Practice Address - Country:US
Practice Address - Phone:716-741-3076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY369774-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered