Individual
MRS. CATHERINE A HAGEDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1520 W 53RD ST, SUITE 2, DAVENPORT, IA 52806-2459
(563) 421-3800
(563) 421-3810
Mailing address
1520 W 53RD ST, SUITE 2, DAVENPORT, IA 52806-2459
(563) 421-3800
(563) 421-3810
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
001550
IA
363AM0700X
Medical Physician Assistant
Primary
001550
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770552051
BLUE SHIELD
IA
Enumeration date
03/17/2006
Last updated
07/20/2021
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