Provider Demographics
NPI:1881075802
Name:HAGER, MARIE A (APRN FNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:A
Last Name:HAGER
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:CENTER CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03813-0446
Mailing Address - Country:US
Mailing Address - Phone:207-632-9881
Mailing Address - Fax:603-447-5148
Practice Address - Street 1:47 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-6057
Practice Address - Country:US
Practice Address - Phone:603-662-4680
Practice Address - Fax:855-609-1958
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP141122363LF0000X
NH053982-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily