Individual
KARISSA M HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14 MEDICAL PARK DRIVE SUITE 320, COLUMBIA, SC 29203
(803) 434-6771
(803) 434-3955
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
24338
SC
Other
Enumeration date
03/30/2021
Last updated
07/20/2021
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