Individual
LYDIA HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
711 H ST, STE 100, ANCHORAGE, AK 99501-3446
(907) 770-0862
(907) 770-1730
Mailing address
840 W FERN AVE, PALMER, AK 99645-6518
(907) 250-1599
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6165
AK
Other
Enumeration date
12/24/2012
Last updated
12/24/2012
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