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Individual

SHANE HAGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP, AGACNP, FNP

Contact information

Practice address
7709 W 151ST ST, OVERLAND PARK, KS 66223-2219
(916) 600-5808
(913) 600-5838
Mailing address
7709 W 151ST ST, OVERLAND PARK, KS 66223-2219
(816) 447-6138

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-81393-121
KS
363LA2100X
Acute Care Nurse Practitioner
2016000962
MO
363LF0000X
Family Nurse Practitioner
2019001965
MO

Other

Enumeration date
07/06/2016
Last updated
01/31/2025
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