Provider Demographics
NPI:1225908338
Name:HAGEN, CHRISTELLE JOY KALLIO (CLD)
Entity type:Individual
Prefix:
First Name:CHRISTELLE
Middle Name:JOY KALLIO
Last Name:HAGEN
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15072 62ND ST N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6815
Mailing Address - Country:US
Mailing Address - Phone:651-403-3556
Mailing Address - Fax:
Practice Address - Street 1:15072 62ND ST N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6815
Practice Address - Country:US
Practice Address - Phone:651-403-3556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula