Provider Demographics
NPI:1891558086
Name:JAGER, HANNA NICOLE (NP)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:NICOLE
Last Name:JAGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:NICOLE
Other - Last Name:LOPATRIELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7741 SVL BOX
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5160
Mailing Address - Country:US
Mailing Address - Phone:760-887-0176
Mailing Address - Fax:
Practice Address - Street 1:7741 SVL BOX
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5160
Practice Address - Country:US
Practice Address - Phone:760-887-0176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily