| Katie Hagerstrom, MSN, APNP, AGPC-BC | |
|
1746 Paul Dr, Kaukauna, WI 54130-3014 | |
| (920) 422-7402 | |
| (920) 543-5288 |
| Full Name | Katie Hagerstrom |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 1746 Paul Dr, Kaukauna, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972994093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 16206-33 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Prn Home Health & Therapy, Llc | Appleton, WI | Home health agency |
| Bellin Memorial Hospital | Green bay, WI | Hospital |
| Thedacare Regional Medical Center - Appleton Inc | Appleton, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sequoia Integrative Medical Services Llc | 8527480250 | 7 |
| Entity Name | Sequoia Integrative Medical Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790312171 PECOS PAC ID: 8527480250 Enrollment ID: O20200625000133 |
| Mailing Address | Practice Location Address |
|---|---|
| Katie Hagerstrom, MSN, APNP, AGPC-BC 253 Patricia Ln, Wrightstown, WI 54180-1201 Ph: (920) 512-6489 | Katie Hagerstrom, MSN, APNP, AGPC-BC 1746 Paul Dr, Kaukauna, WI 54130-3014 Ph: (920) 422-7402 |
Hamza Shahran, MD Geriatric Medicine Medicare: Accepting Medicare Assignments Practice Location: 1500 Arbor Way, Kaukauna, WI 54130 Phone: 920-766-3200 | |
Andrew C Pahl, M.D. Geriatric Medicine Medicare: Not Enrolled in Medicare Practice Location: 2700 Crooks Ave, Kaukauna, WI 54130 Phone: 920-830-5900 Fax: 920-738-5787 |