Hagstrom, Caitlyn

Hagstrom, Caitlyn is an individual health care provider with primary practice located at 4225 Golden Valley Rd , Golden Valley MN 55422-4215. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Hagstrom, Caitlyn can be contacted via phone (763) 588-0661.

Contact Information

Primary practice address
4225 Golden Valley Rd Golden Valley MN 55422-4215
Phone: (763) 588-0661
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Minnesota

Profile Details

NPI number 1619649936
LBN Legal business name Hagstrom, Caitlyn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2021
Last updated May 18th, 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 1619649936 NPPES
Minnesota MEDICAID 1619649936

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