| Doctor Name: | NIKKI LYNNE HAGEN |
| NPI Number: | 1174959183 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 041.138021 |
| Business Practice Address: | 15953 Aime Ln Wadsworth, IL - 600839626 |
| Business Phone Number: | 8476232616 |
| Business Fax Number: | |
| Mailing Address: | 15953 Aime Ln, WADSWORTH |
| State: | IL |
| Postal Code: | 600839626 |
| Phone Number: | 8476232616 |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2013 |
| NPI Last Update Date: | 09/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0102X |
| License Number: | 041.138021 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Maternal Newborn |
| Taxonomy Definition: | |