Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN11011862 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | APRN1101862 | FL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN1101862 | FL |
NPI | 1538753843 |
---|---|
Provider Name | Jason L Hagan |
First Address | Tampa, FL 33610-1208 |
Second Address | Tampa, FL 33607-6307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2021 |
Last Update Date | 24/10/2021 |