Doctor Name: | KATRINA L HAGAN |
NPI Number: | 1609216134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.P.R.N. |
License Number: | 3008094 |
Business Practice Address: | 300 High Point Ct Mount Washington, KY - 400476560 |
Business Phone Number: | 5029556129 |
Business Fax Number: | 5029558161 |
Mailing Address: | Po Box 950202, LOUISVILLE |
State: | KY |
Postal Code: | 402950202 |
Phone Number: | 5022725067 |
Fax Number: | 5022725339 |
NPI Enumeration Date: | 06/28/2013 |
NPI Last Update Date: | 09/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3008094 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |