Individual
DEBORAH L HAGELSTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3502 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7671
(325) 658-1511
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
234895
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127215502
—
TX
01
—
83N937
MEDICARE
TX
Enumeration date
02/20/2006
Last updated
11/09/2018
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