Individual
MS. TRESA HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4624 FANNING DR, ANTIOCH, TN 37013-2729
(615) 969-4739
Mailing address
4624 FANNING DR, ANTIOCH, TN 37013-2729
(615) 969-4739
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000061212
TX
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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