Individual
DEANA HAGAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1755 KIRBY PKWY, MEMPHIS, TN 38120-4398
(901) 725-5846
(901) 726-4827
Mailing address
PO BOX 171306, MEMPHIS, TN 38187-1306
(901) 725-5846
(901) 726-4827
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
96761
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126472
—
MS
05
—
3630431
—
TN
01
—
4040862
BLUE CROSS
TN
01
—
430070367
RAILROAD MEDICARE
—
Enumeration date
06/03/2006
Last updated
03/06/2009
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