Individual
JOANN HAGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
8801 S 101ST EAST AVE, TULSA, OK 74133-5716
(918) 294-6911
(918) 294-4759
Mailing address
8801 S 101ST EAST AVE, TULSA, OK 74133-5716
(918) 294-6911
(918) 294-4759
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1151
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200093200A
—
OK
05
—
470748011-12
—
NE
Enumeration date
02/07/2006
Last updated
12/13/2007
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