Individual
NATHAN HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 502-7000
Mailing address
PO BOX 504407, SAINT LOUIS, MO 63150-4407
(816) 502-7000
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
2016000454
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009017999
LICENSE
MO
01
—
2016000454
NP LICENSE
MO
Enumeration date
11/11/2015
Last updated
01/08/2016
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