Individual
NICOLE ANNETTE HAGEDORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2680 HENDERSON DR STE 5, JACKSONVILLE, NC 28546-5297
(910) 355-0442
(910) 355-0443
Mailing address
2680 HENDERSON DR STE 5, JACKSONVILLE, NC 28546-5297
(910) 355-0442
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
78537
NC
Other
Enumeration date
06/22/2005
Last updated
07/21/2022
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