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Individual

EMILIE A HAGAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ARNP, CDE

Contact information

Practice address
1431 BLUFFVIEW ST, STE. 102, WICHITA, KS 67218-3039
(316) 219-3571
(316) 219-3573
Mailing address
7329 N WOODLAWN ST, VALLEY CENTER, KS 67147-8560
(316) 219-3571
(316) 219-3573

Taxonomy

Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
74122
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
207996
HEALTH PARTNERS OF KANSAS
KS
01
3413735
CIGNA INS ID
KS
01
436680
FIRST GUARD - MEDICAID
KS
01
9383
PREFERRED HEALTH CARE ID
KS
Enumeration date
01/09/2006
Last updated
07/08/2007
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