Provider Demographics
NPI:1881075505
Name:HASENAUER, MAREESA LAUREN (APRN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:MAREESA
Middle Name:LAUREN
Last Name:HASENAUER
Suffix:
Gender:F
Credentials:APRN, NP-C
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Mailing Address - Street 1:39241 S HANSEN RD
Mailing Address - Street 2:
Mailing Address - City:WELLFLEET
Mailing Address - State:NE
Mailing Address - Zip Code:69170-7095
Mailing Address - Country:US
Mailing Address - Phone:308-530-2053
Mailing Address - Fax:
Practice Address - Street 1:302 E 6TH ST
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:NE
Practice Address - Zip Code:69025-6102
Practice Address - Country:US
Practice Address - Phone:308-367-4162
Practice Address - Fax:308-367-4164
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2017-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE111822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1095147Medicare PIN