Individual
KIMBERLY R HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3334 CAPITAL MEDICAL BLVD #400, TALLAHASSEE, FL 32308
(850) 877-8174
(850) 877-5636
Mailing address
3334 CAPITAL MEDICAL BLVD #400, TALLAHASSEE, FL 32308
(850) 877-8174
(850) 877-5636
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9185998
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000690200
—
FL
Enumeration date
11/01/2006
Last updated
11/04/2019
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