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General NPI Number Information
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NPI Number | 1144894452
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Entity Type | Individual
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Provider Name | KIERA ANN HAGAN OD
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Gender | Female
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 4710 SPOTSYLVANIA PKWY
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-9433
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Country | US
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Telephone | 540-741-2733
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Fax |
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Provider Business Mailing Address
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Address Line | 4371 PALTON DR
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City | DUMFRIES
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State | VA
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Zip | 22025-2031
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Country | US
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Telephone | 954-940-1999
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618003381
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License Number State | VA
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