Individual
MARTHA M HAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2215 LANDOVER PL, LYNCHBURG, VA 24501-2115
(434) 947-3944
(434) 544-2316
Mailing address
2215 LANDOVER PL, LYNCHBURG, VA 24501-2115
(434) 947-3944
(434) 544-2316
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024167533
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024167533
STATE LICENSE NUMBER
VA
01
—
015160M68
MEDICARE
VA
05
—
1316134877
—
VA
01
—
541131672006
TRICARE
VA
01
—
P00458960
MEDICARE RAILROAD CARRIER
VA
Enumeration date
09/28/2007
Last updated
04/13/2010
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