Provider Demographics
NPI:1124662275
Name:HAGAN NUTRITION CONSULTING
Entity type:Organization
Organization Name:HAGAN NUTRITION CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CDE, RN
Authorized Official - Phone:412-436-9219
Mailing Address - Street 1:120 WALNUT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1211
Mailing Address - Country:US
Mailing Address - Phone:412-436-9219
Mailing Address - Fax:
Practice Address - Street 1:1386 OLD FREEPORT RD STE 3A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3115
Practice Address - Country:US
Practice Address - Phone:412-436-9219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty