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NPI Code Detail

MEDICARE: JORDAN P HAGANS

MEDICARE:   JORDAN P HAGANS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WE0003XEmergency Registered NurseRN9618354FL

General Provider Information

NPI Number : 1245162767
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN P HAGANS
Provider Business Mailing Address
First Line : 573 SW LACONIC AVE
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34953-3038
Country : US
Telephone Number : 772-480-9523
Fax Number :
Provider Business Practice Location Address
First Line : 1700 S 23RD ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-4803
Country : US
Telephone Number : 771-461-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ JORDAN P HAGANS ” Practice Location

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