Individual
CHARLENE MICHELLE HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
622 W MAPLE ST, SUITE B, FARMINGTON, NM 87401-6590
(505) 327-4867
(505) 327-5355
Mailing address
622 W MAPLE ST, SUITE B, FARMINGTON, NM 87401-6590
(505) 327-4867
(505) 327-5355
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-01673
NM
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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