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NPI Code Detail

MEDICARE: MAGEN HANZEL

MEDICARE: MAGEN HANZEL
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
1164W00000XLicensed Practical Nurse2011000751MO

General Provider Information

NPI Number : 1861913162
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGEN HANZEL
Provider Business Mailing Address
First Line : 1800 COMMUNITY
Second Line :
City : CLINTON
State : MO
Zip : 64735-8804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1700 W MAIN ST
Second Line :
City : SEDALIA
State : MO
Zip : 65301-3635
Country : US
Telephone Number : 660-826-5885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2017
Last Update Date : 06/28/2017

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Directions to “ MAGEN HANZEL ” Practice Location

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