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General NPI Number Information
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NPI Number | 1972994093
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Entity Type | Individual
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Provider Name | KATIE HAGERSTROM MSN, APNP, AGPC-BC
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Gender | Female
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1746 PAUL DR
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City | KAUKAUNA
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State | WI
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Zip | 54130-3014
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Country | US
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Telephone | 920-422-7402
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Fax | 920-543-5288
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Provider Business Mailing Address
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Address Line | 253 PATRICIA LN
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City | WRIGHTSTOWN
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State | WI
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Zip | 54180-1201
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Country | US
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Telephone | 920-512-6489
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 16206-33
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License Number State | WI
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