KELLY MARIE HAGNER (NPI# 1144827734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144827734 |
| Entity Type | Individual |
| Full Name | KELLY MARIE HAGNER |
| Credential | APNP |
| Practice Address |
480 E Division St Fond Du Lac WI 54935-3734 |
| Practice Telephone | 9209264100 |
| Practice Fax Number | 9209264190 |
| Mailing Telephone | 9209264100 |
| Mailing Fax Number | 9209264190 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 10452-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
480 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-3734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164403226 | Michael W Jones | Internal Medicine | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2005-11-07 |
| 1952735516 | Lisa Mae Michels | Nurse Practitioner | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2013-08-30 |
| 1376899393 | Sameer Tolay | Internal Medicine | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2012-07-27 |
| 1902174089 | Rebecca L Lentscher | Nurse Practitioner | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2011-12-05 |
| 1700101250 | Adam Lawrence Liss | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2010-03-27 |
| 1174756696 | Filip T Troicki | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2009-09-01 |
| 1124245253 | Lori J Wendt | Nurse Practitioner | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2007-04-19 |
| 1114938156 | Hong Chu Wang | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2006-08-11 |
| 1144247941 | Central Wisconsin Radiation Oncology, S.c. | Radiology | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2006-07-16 |
| 1861438913 | Agnesian Healthcare | Durable Medical Equipment & Medical Supplies | 480 E Division St, Fond Du Lac, WI 54935-3734 | 2006-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932608619 | Nathan Edward Adams | Nurse Practitioner | W5270 Bechaud Beach Dr, Fond Du Lac, WI 54935-1920 | 2018-02-07 |
| 1396736948 | Carol Delwiche | Nurse Practitioner | 1107 E Johnson St, Fond Du Lac, WI 54935-8925 | 2005-11-02 |
| 1497308233 | Kelly Jo Rehfeldt | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-22 |
| 1083184501 | Nicole A Stodola | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2018-11-27 |
| 1619471117 | Brittany Kornfehl | Nurse Practitioner | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2018-03-20 |
| 1508387127 | Nancy Diane Preder | Nurse Practitioner | 305 Camelot Dr, Fond Du Lac, WI 54935-8014 | 2017-07-05 |
| 1598112963 | Jennifer M Halbach | Nurse Practitioner | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-05-16 |
| 1093190860 | Kasandra Flasch | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2015-07-22 |
| 1356725543 | Jolene K Oehlke | Nurse Practitioner | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2015-07-17 |
| 1063812857 | Faye M Franklin | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2014-08-28 |
| Find all providers in FOND DU LAC | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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| 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.