Provider Demographics
NPI:1588626485
Name:HAGUE, DENISE MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:MARIE
Last Name:HAGUE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:DENISE
Other - Middle Name:MARIE
Other - Last Name:NADEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:N6971 CTY RD CC
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54767
Mailing Address - Country:US
Mailing Address - Phone:715-778-4827
Mailing Address - Fax:
Practice Address - Street 1:N750 DOUG BLEGEN DR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:WI
Practice Address - Zip Code:54767-8806
Practice Address - Country:US
Practice Address - Phone:715-778-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31733-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39994500Medicaid