Individual
ZACHARY GORDON HAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 390-0762
Mailing address
822 CRIMSON CT, RAPID CITY, SD 57701-6505
(605) 390-0762
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
SD-RNR036473
SD
367500000X
Certified Registered Nurse Anesthetist
CR000911
SD
Other
Enumeration date
03/16/2016
Last updated
04/01/2016
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