Provider Demographics
NPI:1437887742
Name:HAGUE, VICTORIA
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:HAGUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 W AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1031
Mailing Address - Country:US
Mailing Address - Phone:850-460-0034
Mailing Address - Fax:
Practice Address - Street 1:3201 W AIRPORT RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-1031
Practice Address - Country:US
Practice Address - Phone:850-460-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-13
Last Update Date:2022-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program