Provider Demographics
NPI:1205937182
Name:HASSE-JUNGKURTH, CAROL S (CRNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:S
Last Name:HASSE-JUNGKURTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 JUSTISON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5162
Mailing Address - Country:US
Mailing Address - Phone:023-660-3394
Mailing Address - Fax:302-421-6973
Practice Address - Street 1:1072 JUSTISON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5162
Practice Address - Country:US
Practice Address - Phone:302-666-3394
Practice Address - Fax:302-421-6973
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007196363LC0200X, 363LA2200X
DELP-0010464363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine