Provider Demographics
NPI:1235720657
Name:HAGER, ABIGAIL ROSE
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ROSE
Last Name:HAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 RAVENHILL DR
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-9204
Mailing Address - Country:US
Mailing Address - Phone:913-367-2131
Mailing Address - Fax:913-674-2023
Practice Address - Street 1:800 RAVENHILL DR
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-9204
Practice Address - Country:US
Practice Address - Phone:913-367-2131
Practice Address - Fax:913-674-2023
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program