Hagan, Tracy R

Hagan, Tracy R is an individual health care provider with primary practice located at 900 Hospital Dr , Madisonville KY 42431-1644. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Hagan, Tracy R can be contacted via phone (270) 825-5800.

Contact Information

Primary practice address
900 Hospital Dr Madisonville KY 42431-1644
Phone: (270) 825-5800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 71001230B Indiana
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 3005183 Kentucky

Profile Details

NPI number 1558324715
LBN Legal business name Hagan, Tracy R
Credentials Advanced Oncology Certified Nurse Practitioner (AOCNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Dec 3rd, 2020 - about 6 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 1558324715 NPPES
Other P00082583 RR MEDICARE
MEDICAID 200445130 RR MEDICARE
MEDICAID 78007838 RR MEDICARE
Other P01079960 RR MEDICARE

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