MS. RAEDENE ANN HAGEMAN (NPI# 1275962219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275962219 |
| Entity Type | Individual |
| Full Name | MS. RAEDENE ANN HAGEMAN |
| Credential | FNP-C |
| Practice Address |
2621 Maple Lane Show Low AZ 85902-3526 |
| Mailing Address |
Po Box 3526 2621 Maple Ln Show Low AZ 85902-3526 |
| Practice Telephone | 9282059863 |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2019-04-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP5138 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2621 MAPLE LANE |
| City | SHOW LOW |
| State | AZ |
| Zip Code | 85902-3526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124057666 | Northland Therapy Services Inc | Physical Therapist | 1294 Fawnbrook Drive, Showlow, AZ 85902 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627965 | White Mountain Mobile Care | Nurse Practitioner | 650 N Penrod Rd # 533, Show Low, AZ 85901-5284 | 2020-07-27 |
| 1881202653 | Carly Anne Dalmolin | Counselor | 2500 E Show Low Lake Rd Bldg A, Show Low, AZ 85901-7994 | 2020-07-17 |
| 1972121861 | Jessica Dixon | Nurse Practitioner | 4951 S White Mountain Rd Bldg A3, Show Low, AZ 85901-7827 | 2020-07-08 |
| 1316567720 | Banner Urgent Care Arizona LLC | Clinic/Center | 680 E Deuce of Clubs Ste B, Show Low, AZ 85901-4829 | 2020-04-26 |
| 1801425434 | Timber Mesa Fire and Medical District | Ambulance | 3561 E Deuce of Clubs, Show Low, AZ 85901-5329 | 2020-04-06 |
| 1316570260 | Show Low Assisted Living LLC | Assisted Living Facility | 965 Full House Ln, Show Low, AZ 85901-4044 | 2020-02-19 |
| 1861023921 | Courtney Ann Mackinnon | Nurse Practitioner | 5300 S Sutter Dr Ste 11, Show Low, AZ 85901-8055 | 2020-01-28 |
| 1689212508 | Changepoint Integrated Health | Clinic/Center | 1500 S White Mountain Rd Bldg 3, Show Low, AZ 85901-7111 | 2019-12-11 |
| 1396382750 | Recoveryworks, LLC | Substance Abuse Rehabilitation Facility | 1201 E Cooley St Ste A, Show Low, AZ 85901-5145 | 2019-12-04 |
| 1447804935 | Katie Kline | Counselor | 2051 Evergreen Ln Ste C, Show Low, AZ 85901-7928 | 2019-08-01 |
| Find all providers in SHOW LOW | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627965 | White Mountain Mobile Care | Nurse Practitioner | 650 N Penrod Rd # 533, Show Low, AZ 85901-5284 | 2020-07-27 |
| 1972121861 | Jessica Dixon | Nurse Practitioner | 4951 S White Mountain Rd Bldg A3, Show Low, AZ 85901-7827 | 2020-07-08 |
| 1043673262 | Kelly Curiel | Nurse Practitioner | 2061 S Canyon Ridge Trl, Show Low, AZ 85901-6798 | 2016-04-04 |
| 1093148991 | Brandie Dianna Griffin | Nurse Practitioner | 2500 E Hunt Dr Ste H, Show Low, AZ 85901-7954 | 2013-08-14 |
| 1780670398 | Debra L Bergstrom | Nurse Practitioner | 1500 S White Mountain Rd, Suite 401, Show Low, AZ 85901-7111 | 2005-09-20 |
| 1336705151 | Amber Luna | Nurse Practitioner | 320 E Deuce of Clubs, Show Low, AZ 85901-4808 | 2019-05-16 |
| 1598321481 | Ashley Marie Smith | Nurse Practitioner | 320 E Deuce of Clubs, Show Low, AZ 85901-4808 | 2019-05-15 |
| 1174187546 | Constance L Collman | Nurse Practitioner | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2019-04-30 |
| 1851870919 | Mary Jane Wild Sorenson | Nurse Practitioner | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2018-08-09 |
| 1235641382 | Nicolette Broby | Nurse Practitioner | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-10-30 |
| Find all providers in SHOW LOW | ||||
Please comment or provide details below to improve the information on MS. RAEDENE ANN HAGEMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.