Basic Information
| Provider Information | |||||||||
| NPI: | 1336230499 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HASLER | ||||||||
| FirstName: | TRACY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | RN ANP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5752 DEER HILL RD | ||||||||
| Address2: | |||||||||
| City: | WATERLOO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622986320 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 509 HAMACHER ST | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | WATERLOO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622981592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6189392273 | ||||||||
| FaxNumber: | 6189390245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 03/10/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 209007522 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.