Individual
MS. CARRIE HAGBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCP
Contact information
Practice address
400 22ND AVE., BROOKINGS, SD 57006-2497
(605) 697-9500
(605) 697-6939
Mailing address
400 22ND AVE., BROOKINGS, SD 57006-2497
(605) 697-9500
(605) 697-6939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0126
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6820352
—
SD
Enumeration date
05/16/2006
Last updated
09/24/2007
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