Provider Demographics
NPI:1912712001
Name:HASCALL, DESARAE DAWN
Entity type:Individual
Prefix:
First Name:DESARAE
Middle Name:DAWN
Last Name:HASCALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BAYARD
Mailing Address - State:NE
Mailing Address - Zip Code:69334-2003
Mailing Address - Country:US
Mailing Address - Phone:308-279-0011
Mailing Address - Fax:
Practice Address - Street 1:10650 AVENUE C
Practice Address - Street 2:
Practice Address - City:BAYARD
Practice Address - State:NE
Practice Address - Zip Code:69334-2003
Practice Address - Country:US
Practice Address - Phone:308-279-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion