Individual
TABITHA M HASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1412 MAIN STREET, HAWLEY, MN 56549
(218) 483-3567
(218) 483-3567
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10542
MN
363AM0700X
Medical Physician Assistant
1244
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71104
—
ND
Enumeration date
01/30/2009
Last updated
12/14/2021
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