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Individual

JANICE H HAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-BC

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3423
SC
363LA2100X
Acute Care Nurse Practitioner
5003891
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7006373
NC
01
NC9144A
MEDICARE PTAN
NC
Enumeration date
01/28/2008
Last updated
06/15/2015
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