Individual
MRS. JESSICA LAUREN HAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
9121 SAM FURR RD STE 108, HUNTERSVILLE, NC 28078-8235
(704) 324-3590
(704) 324-3591
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5006930
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003220518
—
NC
01
—
268791
NC MEDICAID LICENSE
NC
05
—
NP2818
—
SC
Enumeration date
06/12/2014
Last updated
05/18/2023
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