Individual
DUSTY RAE HANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
DIAGNOSTIC CLINIC OF LONGVIEW, 2901 N FOURTH ST, LONGVIEW, TX 75605
(903) 758-1818
Mailing address
PO BOX 610393, DALLAS, TX 75261-0393
(903) 757-6042
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP145659
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP145659
TX
363LG0600X
Gerontology Nurse Practitioner
AP145659
TX
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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