Hagan, Kelsey Louise

Hagan, Kelsey Louise is an individual health care provider with primary practice located at 4215 Burns Rd Ste 100 , Palm Beach Gardens FL 33410-4627. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Hagan, Kelsey Louise can be contacted via phone (561) 694-7776.

Contact Information

Primary practice address
4215 Burns Rd Ste 100 Palm Beach Gardens FL 33410-4627
Phone: (561) 694-7776
Fax: (561) 694-3099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9112977 Florida

Profile Details

NPI number 1164041059
LBN Legal business name Hagan, Kelsey Louise
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2020
Last updated Feb 11th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164041059 NPPES
Florida MEDICAID 254016972

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