Provider Demographics
NPI:1811564289
Name:HAGAN, CLAIRE (APRN)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:
Last Name:HAGAN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 MCELROY PIKE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-9321
Mailing Address - Country:US
Mailing Address - Phone:270-699-0703
Mailing Address - Fax:
Practice Address - Street 1:1698 OLD LEBANON RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-3319
Practice Address - Country:US
Practice Address - Phone:270-789-2445
Practice Address - Fax:270-465-4669
Is Sole Proprietor?:No
Enumeration Date:2021-06-05
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3016194363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100779490Medicaid