Provider Demographics
NPI:1770124091
Name:HAGLER, SYBIL ROCHELLE (CRNP)
Entity type:Individual
Prefix:MS
First Name:SYBIL
Middle Name:ROCHELLE
Last Name:HAGLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:SYBIL
Other - Middle Name:ROCHELLE
Other - Last Name:HEWITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2648
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-2648
Mailing Address - Country:US
Mailing Address - Phone:205-558-2158
Mailing Address - Fax:205-930-1575
Practice Address - Street 1:1400 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1502
Practice Address - Country:US
Practice Address - Phone:205-930-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-118081363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health