Hagemann, Brenda Kay

Hagemann, Brenda Kay is an individual health care provider with primary practice located at 701 Lewiston St , Cottonwood ID 83522-9750. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Hagemann, Brenda Kay can be contacted via phone (208) 962-3267.

Contact Information

Primary practice address
701 Lewiston St Cottonwood ID 83522-9750
Phone: (208) 962-3267
Fax: (208) 962-2313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP300A Idaho

Profile Details

NPI number 1992708671
LBN Legal business name Hagemann, Brenda Kay
Credentials MSN, APRN, BC FNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Sep 27th, 2019 - about 5 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 1992708671 NPPES
Idaho MEDICAID 804211800

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