Individual
KAYLA HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
8650 BIG BEND BLVD, SAINT LOUIS, MO 63119-3839
(314) 961-5222
Mailing address
8650 BIG BEND BLVD, SAINT LOUIS, MO 63119-3839
(314) 961-5222
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2014025413
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014025413
MISSOURI BOARD OF PHARMACY
MO
Enumeration date
07/12/2018
Last updated
07/12/2018
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