| NPI | 1932500188 |
|---|---|
| Former Name | JACLYN MARIE HAGEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OH 0031117) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: OH 333823) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2022-05-19 |