Provider Demographics
NPI:1649417809
Name:MICHELLE ABBE HACKER, PLLC
Entity Type:Organization
Organization Name:MICHELLE ABBE HACKER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DIANES
Authorized Official - Last Name:HACKER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:940-641-3601
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76241-1239
Mailing Address - Country:US
Mailing Address - Phone:940-665-9863
Mailing Address - Fax:940-668-8986
Practice Address - Street 1:302 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-5015
Practice Address - Country:US
Practice Address - Phone:940-641-3601
Practice Address - Fax:940-295-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX658966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ02758Medicare UPIN
TXNP0385Medicare PIN