Healthcare Provider Details

I. General information

NPI: 1851203749
Provider Name (Legal Business Name): KAREN-KAY KILEE HAGERSTRAND ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 N LA CHOLLA BLVD STE 200
TUCSON AZ
85741-3549
US

IV. Provider business mailing address

11084 W BROWN WARE ST
MARANA AZ
85658-4632
US

V. Phone/Fax

Practice location:
  • Phone: 520-382-8200
  • Fax:
Mailing address:
  • Phone: 520-404-3649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberATR-009326
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: