| Doctor Name: | TARA NIKOLE HAGER |
| NPI Number: | 1629367636 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 3006827 |
| Business Practice Address: | 207 Fairgrounds Rd Hardinsburg, KY - 401432585 |
| Business Phone Number: | 2707565816 |
| Business Fax Number: | 2707565815 |
| Mailing Address: | 107 Cranes Roost Ct, ELIZABETHTOWN |
| State: | KY |
| Postal Code: | 427013650 |
| Phone Number: | 2707652605 |
| Fax Number: | 2702348572 |
| NPI Enumeration Date: | 03/30/2011 |
| NPI Last Update Date: | 11/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 3006827 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |