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General NPI Number Information
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NPI Number | 1144280470
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Entity Type | Individual
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Provider Name | CHARLES M HAGEDORN CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 601 E 14TH ST
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City | SEDALIA
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State | MO
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Zip | 65301-5972
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Country | US
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Telephone | 660-829-7744
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Fax | 660-827-7678
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Provider Business Mailing Address
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Address Line | 22432 DOC RHODES DR
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City | WARSAW
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State | MO
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Zip | 65355-6931
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Country | US
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Telephone | 402-245-8446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 100561
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2006032655
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 55374
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License Number State | KS
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