BRYAN M HAGEN (NPI# 1790872000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790872000 |
Entity Type | Individual |
Full Name | BRYAN M HAGEN |
Credential | DNP, PMHNP |
Practice Address |
2955 N Highway 97 Ste 100 Bend OR 97703-7559 |
Practice Telephone | 5413138501 |
Practice Fax Number | 5412412363 |
Mailing Telephone | 5413138501 |
Mailing Fax Number | 5412412363 |
Enumeration Date | 2006-10-06 |
Last Update Date | 2020-09-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
201042999RN | OR | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201250173NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 500689745 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
19800 Village Office Ct Ste 102, Bend, OR 977021813 | 5413138501 | 5412412363 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235276973 | Bryan P Hagen | Pharmacist | 426 10th St, Worthington, MN 56187-2341 | 2007-01-31 |
Street Address |
2955 N HIGHWAY 97 STE 100 |
City | BEND |
State | OR |
Zip Code | 97703-7559 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033718242 | Hagen Psychiatry LLC | Nurse Practitioner | 2955 N Highway 97 Ste 100, Bend, OR 97703-7559 | 2020-10-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285250704 | Elizabeth Jane Lindt | Counselor | 63311 Jamison Street, Bend, OR 97703 | 2020-06-20 |
1790318145 | Leah Alice Williamson | Counselor | 118 Nw Thurston Ave, Bend, OR 97703 | 2020-02-13 |
1831658301 | Pretty Moments Lingerie, LLC | Durable Medical Equipment & Medical Supplies | 63455 N Hwy 97 Suite 44, Bend, OR 97703 | 2019-03-14 |
1821561150 | Kevin Hallmeyer | Chiropractor | 750 Nw Charbonneau St., Suite 101, Bend, OR 97703 | 2019-01-09 |
1346743267 | Jesse Maggie Mae Abraham | Massage Therapist | 39 Nw Lousiana Ave, Bend, OR 97703 | 2018-03-16 |
1891202396 | Jerod Paul Michael | Speech-Language Pathologist | 2736 Nw Crossing Dr, Ste. 120, Bend, OR 97703 | 2018-01-05 |
1952823023 | Dan Packman | Massage Therapist | 2955 N. Hwy 97, Ste 105, Riverside Wellness, Voila Massage, Bend, OR 97703 | 2017-07-11 |
1023460102 | Brennon Patrick Moore | Counselor | 835 Nw Bond St Ste 100, Bend, OR 97703 | 2016-07-12 |
1093160269 | Eric Hinds | Optometrist | 63455 N Highway 97 Ste 75, Bend, OR 97703 | 2016-04-25 |
1417316191 | Ronald Guiley Od, Mph, PC | Clinic/Center | 63455 N Hwy 97, Ste 75, Bend, OR 97703 | 2016-02-23 |
Find all providers in zip 97703 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578934535 | Kimberly Sue Butler | Nurse Practitioner | 339 Sw Century Dr Ste 101, Bend, OR 97702-1199 | 2015-10-15 |
1528317898 | Kara Lynn Kelly | Nurse Practitioner | 339 Sw Century Dr, Suite 101, Bend, OR 97702-1198 | 2012-09-02 |
1114273711 | Deborah Macwilliams | Nurse Practitioner | 731 Nw Franklin Ave Ste 104, Bend, OR 97703 | 2012-08-01 |
1801122668 | Kay Oliver | Nurse Practitioner | 1010 Nw Harriman St, Suite A, Bend, OR 97701-1912 | 2009-10-28 |
1699906305 | Kristin Brooks | Nurse Practitioner | 336 Ne Norton Ave. Ste. 3, Bend, OR 97701-3598 | 2009-07-29 |
1003071499 | Nicholas J Campo IIi | Nurse Practitioner | 233 Sw Wilson Ave Ste 201, Bend, OR 97702-2988 | 2008-07-24 |
1922180777 | Deborah Padgett Coehlo | Nurse Practitioner | 62930 O B Riley Rd Ste 300, Bend, OR 97703-9459 | 2006-10-20 |
1033718242 | Hagen Psychiatry LLC | Nurse Practitioner | 2955 N Highway 97 Ste 100, Bend, OR 97703-7559 | 2020-10-19 |
1235766510 | Richard Dean Akers | Nurse Practitioner | 2577 Ne Courtney Dr, Bend, OR 97701-7752 | 2020-03-25 |
1952854481 | Kara Kelly, LLC | Nurse Practitioner | 2955 N Hwy 97, Suite 102, Bend, OR 97703-7559 | 2016-08-02 |
Find all providers in BEND |
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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.