Individual
NATALIE ANN HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
11951 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5171
(951) 204-8111
Mailing address
11951 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5171
(951) 204-8111
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95025553
CA
363LC0200X
Critical Care Medicine Nurse Practitioner
95025553
CA
363LG0600X
Gerontology Nurse Practitioner
95025553
CA
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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