Individual
MS. ANGIE LE'ALICE HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPM, CNP
Contact information
Practice address
1511 S LIME ST, DEMING, NM 88030-6207
(575) 538-2981
(855) 653-5023
Mailing address
1511 S LIME ST, DEMING, NM 88030-6207
(575) 538-2981
(855) 653-5171
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
CNP-02963
NM
176B00000X
Midwife
02431R
NM
363LP2300X
Primary Care Nurse Practitioner
Primary
CNP-02963
NM
Other
Enumeration date
12/13/2009
Last updated
04/15/2022
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