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NPI Code Detail

MEDICARE: ERIN MARIE HAGEMAN APRN

MEDICARE: ERIN MARIE HAGEMAN APRN
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
1363L00000XNurse Practitioner53-78264-041KS

General Provider Information

NPI Number : 1992281778
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN MARIE HAGEMAN APRN
Provider Business Mailing Address
First Line : 550 N HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-4976
Country : US
Telephone Number : 316-962-2156
Fax Number :
Provider Business Practice Location Address
First Line : 550 N HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-4976
Country : US
Telephone Number : 316-962-2156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2018
Last Update Date : 07/16/2018

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