MEDICARE: KATHY A HAGELGANS CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	SP004666B	PA

General Provider Information

NPI Number	:	1346262664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY A HAGELGANS CRNP

Provider Business Mailing Address
First Line	:	304 N WATER ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3374
Country	:	US
Telephone Number	:	717-299-6371
Fax Number	:	717-945-1587

Provider Business Practice Location Address
First Line	:	802 NEW HOLLAND AVE STE 200
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17602-2288
Country	:	US
Telephone Number	:	717-299-6371
Fax Number	:	717-397-8881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	03/27/2018

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