Provider Demographics
NPI:1538882741
Name:HASSELL, DAWNTRESS EVETTE (CNM)
Entity type:Individual
Prefix:MRS
First Name:DAWNTRESS
Middle Name:EVETTE
Last Name:HASSELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 AVENUE D FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5621
Mailing Address - Country:US
Mailing Address - Phone:407-394-5978
Mailing Address - Fax:
Practice Address - Street 1:3819 AVENUE D FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5621
Practice Address - Country:US
Practice Address - Phone:407-394-5978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF002174-01367A00000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife