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Individual
MRS. JACKLYN HAGG
Active
Individual
MRS. JACKLYN HAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
66593
ID
363LA2100X
Acute Care Nurse Practitioner
AP 60730619
WA
Other
Enumeration date
05/05/2017
Last updated
06/17/2021
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