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General NPI Number Information
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NPI Number | 1568048890
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Entity Type | Individual
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Provider Name | STEVE D. HAGAN NP
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Gender | Male
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 726 N LOCUST AVE
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City | LAWRENCEBURG
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State | TN
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Zip | 38464-2865
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Country | US
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Telephone | 931-766-7056
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Fax |
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Provider Business Mailing Address
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Address Line | 581 OLD FLORENCE PULASKI RD
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City | LEOMA
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State | TN
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Zip | 38468-5363
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Country | US
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Telephone | 931-244-0105
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 29059
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License Number State | TN
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