Provider Demographics
NPI:1952066011
Name:HAGMAN, RACHAEL (ARNP)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:HAGMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-1901
Mailing Address - Country:US
Mailing Address - Phone:515-266-1000
Mailing Address - Fax:
Practice Address - Street 1:2301 E 14TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-1901
Practice Address - Country:US
Practice Address - Phone:515-266-1000
Practice Address - Fax:515-266-1824
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA164642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily