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General NPI Number Information
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NPI Number | 1386715571
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Entity Type | Organization
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Legal Business Name | HAGAN & ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/11/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 1431 BLUFFVIEW ST SUITE 108
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City | WICHITA
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State | KS
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Zip | 67218-3039
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Country | US
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Telephone | 316-219-3571
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Fax |
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Provider Business Mailing Address
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Address Line | 7329 N WOODLAWN ST
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City | VALLEY CENTER
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State | KS
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Zip | 67147-8560
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Country | US
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Telephone | 316-219-3571
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. EMILE A. HAGAN
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Credential | ARNP
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Telephone | 316-219-3571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 74122
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License Number State | KS
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