Provider Demographics
NPI:1982674180
Name:HASSELL, SHANNA CARTI' (HS(HEALTH SERVTECH))
Entity Type:Individual
Prefix:MS
First Name:SHANNA
Middle Name:CARTI'
Last Name:HASSELL
Suffix:
Gender:F
Credentials:HS(HEALTH SERVTECH)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:314 ROUNDTREE DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-7872
Mailing Address - Country:US
Mailing Address - Phone:252-338-2489
Mailing Address - Fax:252-334-5420
Practice Address - Street 1:1183 WEEKSVILLE RD
Practice Address - Street 2:BLDG 128
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-8437
Practice Address - Country:US
Practice Address - Phone:252-335-6524
Practice Address - Fax:252-334-5420
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB1662166146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic