Healthcare Provider Details

I. General information

NPI: 1225969710
Provider Name (Legal Business Name): JESSICA HAGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 MYRTLE ST
CADOTT WI
54727-2200
US

IV. Provider business mailing address

426 MYRTLE ST
CADOTT WI
54727-2200
US

V. Phone/Fax

Practice location:
  • Phone: 715-289-3795
  • Fax:
Mailing address:
  • Phone: 715-289-3795
  • Fax: 715-289-3017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number159342
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: