Healthcare Provider Details
I. General information
NPI: 1831193358
Provider Name (Legal Business Name): GERRI LYNN HAGADON-SZAKAL MSN, CNP, DNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/13/2005
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
721 N SHIAWASSEE ST STE 201
OWOSSO MI
48867-1632
US
IV. Provider business mailing address
721 N SHIAWASSEE ST STE 201
OWOSSO MI
48867-1632
US
V. Phone/Fax
- Phone: 989-725-8124
- Fax: 989-723-1205
- Phone: 989-725-8124
- Fax: 989-723-1205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 4704152236 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 4704152236 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: