Individual
ROBERT MANN HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101
(606) 327-4000
Mailing address
3785 RELIABLE PKWY, CHICAGO, IL 60686-0037
(316) 281-3700
(316) 282-4322
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1099A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000209848
ANTHEM BLUE CROSS BLUE SHIELD
KY
05
—
0068541000
—
WV
05
—
0136543
—
OH
05
—
74350562
—
KY
Enumeration date
02/22/2006
Last updated
06/16/2008
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