Provider Demographics
NPI:1306866629
Name:HAGER, KERI D (PHARMD, BCPS)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:D
Last Name:HAGER
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:DH
Other - Last Name:NAGLOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCPS
Mailing Address - Street 1:1110 KIRBY DR
Mailing Address - Street 2:211 LIFE SCIENCE
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-3003
Mailing Address - Country:US
Mailing Address - Phone:218-726-6000
Mailing Address - Fax:218-726-6500
Practice Address - Street 1:1120 KIRBY DR
Practice Address - Street 2:103 KIRBY STUDENT CENTER
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-3085
Practice Address - Country:US
Practice Address - Phone:218-726-6757
Practice Address - Fax:218-726-6751
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist