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NPI Code Detail

MEDICARE: DEBORAH L HAGELSTIEN FNP

MEDICARE: DEBORAH L HAGELSTIEN FNP
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
1363L00000XNurse Practitioner234895TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
183N937OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346215878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH L HAGELSTIEN FNP
Provider Business Mailing Address
First Line : PO BOX 22000
Second Line :
City : SAN ANGELO
State : TX
Zip : 76902-7200
Country : US
Telephone Number : 325-658-1511
Fax Number :
Provider Business Practice Location Address
First Line : 3502 KNICKERBOCKER RD
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-7671
Country : US
Telephone Number : 325-658-1511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 11/09/2018

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