Provider Demographics
NPI:1568749042
Name:HAGEN, ANNE LILLY (RN, MSN, CPNP-AC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:LILLY
Last Name:HAGEN
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Gender:F
Credentials:RN, MSN, CPNP-AC
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Other - Middle Name:
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Mailing Address - Street 1:6300 LA CALMA DRIVE
Mailing Address - Street 2:EMERGENCY SERVICE PARTNERS
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752
Mailing Address - Country:US
Mailing Address - Phone:512-452-8533
Mailing Address - Fax:512-610-0392
Practice Address - Street 1:4900 MUELLER BLVD
Practice Address - Street 2:DELL CHILDRENS MEDICAL CENTER OF CENTRAL TEXAS
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752
Practice Address - Country:US
Practice Address - Phone:512-324-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX530372363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics