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PHYLLIS A HAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
128 ROUTE 27, RAYMOND, NH 03077-1220
(603) 895-3351
(603) 895-0773
Mailing address
128 ROUTE 27, RAYMOND, NH 03077-1220
(603) 895-3351
(603) 895-0773

Taxonomy

Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
016582-21
NH
363LF0000X
Family Nurse Practitioner
Primary
016582-23
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2301906YPNH01
ANTHEM
NH
05
30009619
NH
05
313480099
ME
Enumeration date
08/05/2006
Last updated
10/07/2014
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