Individual
KELLEY ANNE HASENAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
810 W REID AVE, SUITE 4, NORTH PLATTE, NE 69101-6583
(308) 534-0090
(308) 534-0091
Mailing address
810 W REID AVE, SUITE 4, NORTH PLATTE, NE 69101-6583
(308) 534-0090
(308) 534-0091
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
110460
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37425
BCBS PROVIDER NUMBER
NE
Enumeration date
07/31/2006
Last updated
05/18/2012
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