Provider Demographics
NPI:1689871782
Name:HAGAN, JUDITH ANN (CNM)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:HAGAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-1506
Mailing Address - Country:US
Mailing Address - Phone:973-983-7560
Mailing Address - Fax:973-983-6688
Practice Address - Street 1:37 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-1506
Practice Address - Country:US
Practice Address - Phone:973-983-7560
Practice Address - Fax:973-983-6688
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife