Healthcare Provider Details

I. General information

NPI: 1386459329
Provider Name (Legal Business Name): JARED HAGER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 NORTHERN AVE
KANSAS CITY MO
64133-1593
US

IV. Provider business mailing address

918 W 34TH ST
KANSAS CITY MO
64111-3612
US

V. Phone/Fax

Practice location:
  • Phone: 816-861-4700
  • Fax:
Mailing address:
  • Phone: 816-663-3654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number2020020750
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: