MEDICARE: AMARYLLIS ELAINE HAGER CNM, WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	CNM192006	ME
2	176B00000X	Midwife	07663123	NH
3	163W00000X	Registered Nurse	07663121	NH

General Provider Information

NPI Number	:	1316469547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARYLLIS ELAINE HAGER CNM, WHNP

Provider Business Mailing Address
First Line	:	559 PORTSMOUTH AVE
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840-2251
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	559 PORTSMOUTH AVE
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840-2251
Country	:	US
Telephone Number	:	603-436-7588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2017
Last Update Date	:	01/28/2026

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