Individual
LANELL HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 BROADWAY N, FARGO, ND 58102-1420
(701) 293-0221
Mailing address
2800 BROADWAY N, FARGO, ND 58102-1420
(701) 293-0221
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
46707
ND
183500000X
Pharmacist
Primary
RPH5285
ND
Other
Enumeration date
04/16/2013
Last updated
02/17/2026
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