| NPI | 1467466417 |
|---|---|
| Other Name | JACKIE HAGENBUCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN3290112) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP3290112) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-09-19 |