Healthcare Provider Details

I. General information

NPI: 1548839558
Provider Name (Legal Business Name): DALE M HAGER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

IV. Provider business mailing address

211 EDGEFIELD BLVD
MARION OH
43302-5801
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-7400
  • Fax: 419-557-7782
Mailing address:
  • Phone: 740-914-4178
  • Fax: 740-386-2640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0029057
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: