Provider Demographics
NPI:1518309020
Name:HADLEY, MIGEL KAY (ANP)
Entity Type:Individual
Prefix:
First Name:MIGEL
Middle Name:KAY
Last Name:HADLEY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 DEBARR RD STE C205
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2961
Mailing Address - Country:US
Mailing Address - Phone:907-279-2273
Mailing Address - Fax:
Practice Address - Street 1:2741 DEBARR RD STE C205
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-279-2273
Practice Address - Fax:907-258-7705
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1607741Medicaid
AKK165662Medicare PIN