Provider Demographics
NPI:1699746321
Name:HASIK, TERESA ANNE (RN, BSN)
Entity type:Individual
Prefix:MISS
First Name:TERESA
Middle Name:ANNE
Last Name:HASIK
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 BURNS AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3805
Mailing Address - Country:US
Mailing Address - Phone:314-965-8195
Mailing Address - Fax:
Practice Address - Street 1:10810 LAMBERT INTERNATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2314
Practice Address - Country:US
Practice Address - Phone:314-263-6114
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO139403163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse