Individual
KATIE L. HAGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
123 FOX RD, KNOXVILLE, TN 37922-3369
(865) 690-9467
(865) 342-5857
Mailing address
123 FOX RD, KNOXVILLE, TN 37922-3369
(865) 690-9467
(865) 342-5857
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000001547
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1505903
—
TN
01
—
PA0000001547
PA-C LICENSE
TN
Enumeration date
02/20/2008
Last updated
08/04/2020
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