Provider Demographics
NPI:1427295682
Name:HAGLUND, KAYEE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:KAYEE
Middle Name:
Last Name:HAGLUND
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:KAYEE
Other - Middle Name:
Other - Last Name:YAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:332 WEST 87TH STREET
Mailing Address - Street 2:APT 2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:646-248-8703
Mailing Address - Fax:212-532-4362
Practice Address - Street 1:42-09 28TH STREET
Practice Address - Street 2:
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:347-396-7200
Practice Address - Fax:212-532-4362
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY42 420839363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MY1771559OtherDEA