Provider Demographics
NPI:1407314339
Name:HAGEN, ELIZABETH DRU (MSN, RN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:DRU
Last Name:HAGEN
Suffix:
Gender:F
Credentials:MSN, RN, NP-C
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:DRU
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, NP-C
Mailing Address - Street 1:1260 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-1812
Mailing Address - Country:US
Mailing Address - Phone:234-312-2140
Mailing Address - Fax:234-312-2304
Practice Address - Street 1:1260 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1812
Practice Address - Country:US
Practice Address - Phone:234-312-2140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily