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General NPI Number Information
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NPI Number | 1952606634
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Entity Type | Individual
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Provider Name | ANDREA E HAGEN CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 9901 MEDICAL CENTER DR
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City | ROCKVILLE
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State | MD
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Zip | 20850-3357
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Country | US
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Telephone | 240-826-6359
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Fax | 240-826-5393
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Provider Business Mailing Address
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Address Line | 13509 STRAW BALE LN
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City | DARNESTOWN
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State | MD
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Zip | 20878-3993
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Country | US
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Telephone | 301-947-4654
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R150465
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License Number State | MD
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