MEDICARE: ASHLEY POOLE HAGAN CRNA

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
1	163WC0200X	Critical Care Medicine Registered Nurse	1-144965	AL
2	367500000X	Certified Registered Nurse Anesthetist	APRN11043182	FL

General Provider Information

NPI Number	:	1285447375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY POOLE HAGAN CRNA

Provider Business Mailing Address
First Line	:	4820 SW 48TH AVE UNIT 612
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34474-6308
Country	:	US
Telephone Number	:	251-223-3603
Fax Number	:

Provider Business Practice Location Address
First Line	:	6058 ANDHURST DR
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-2609
Country	:	US
Telephone Number	:	251-223-3603
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2025
Last Update Date	:	01/22/2026

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