Individual
DEBORAH J HASSEBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1901 S SHADY STREET, MOUNTAIN CITY, TN 37683-2021
(423) 727-1150
(423) 727-1152
Mailing address
365 STOUT DRIVE BOX 70403, BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4515
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000016767
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1206755
ST LIC
TN
05
—
1529530
—
TN
01
—
16767
ST LIC
TN
Enumeration date
07/30/2012
Last updated
06/24/2016
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