Provider Demographics
NPI:1780287003
Name:HAGEN, DEBRA HELEN (RN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:HELEN
Last Name:HAGEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08827-2535
Mailing Address - Country:US
Mailing Address - Phone:908-537-1042
Mailing Address - Fax:
Practice Address - Street 1:7 GLENN AVE
Practice Address - Street 2:
Practice Address - City:GLEN GARDNER
Practice Address - State:NJ
Practice Address - Zip Code:08826-3629
Practice Address - Country:US
Practice Address - Phone:908-310-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10695300163WH1000X
NJ26NJ01333900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH1000XNursing Service ProvidersRegistered NurseHospice