NPI 1003392770

Demi Elisabeth Hagen, PAC

Practitioner Physician Assistant Wauwatosa, WI

Practice location

Address: 8915 W Connell Ave, Wauwatosa, WI 53226-3067
Phone: (414) 266-2626
Mailing address: 999 N 92nd St, Wauwatosa, WI 53226-4875

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 4529-23 (WI)

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Registry record

NPI: 1003392770
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Jul 2018
Record last updated: 17 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.