Nancy Hagen, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

001961 Issued in CT

Practice address

1340 Sullivan Ave
Prime Healthcare
South Windsor, CT 06074-2713

Phone

(860) 644-1521

Fax

(860) 644-3335

NPI assigned

Dec 23, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hartford Physician Services PC

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1164404117
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1437136140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "address_2": "PRIME HEALTHCARE",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0253",
            "fax_number": "860-263-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 SULLIVAN AVE",
            "address_2": "PRIME HEALTHCARE",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742713",
            "telephone_number": "860-644-1521",
            "fax_number": "860-644-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "NANCY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "001961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "001961",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary T Grillo, DMD
• Jennifer C Guerrette
• Peter Joseph Guida, D.D.S.
• Sreenivas Dutt Gunturu, M.D.
• Juhi Gupta, MS,RD,CDCES
• Victoria Grace Hall, DPT
• Andrew Halpern, LPC
• Laura Hamadi
• Nikisha Bista Hamal, FNP-C
• Martin J. Hancock, M.D.

• Adult Health Nurse Practitioner in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.