Most Relevant Information
Provider Data
| NPI Number: | 1003392770 |
| Provider Name: | DEMI ELISABETH HAGEN PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 4529-23 |
Most Important Dates
| Enumeration Date: | 07/16/2018 |
| Last Updated: | 07/17/2024 |
Provider Practice Location
8915 W CONNELL AVE
WAUWATOSA
WI
532263067
Practice Location Phone/Fax
| Phone: | 4142662626 |
| Fax: |
Provider Mailing Location
999 N 92ND ST
WAUWATOSA
WI
532264875
Provider Mailing Phone/Fax
| Phone: | 4142662000 |
| Fax: |