| Doctor Name: | MARY SUE HAGER |
| NPI Number: | 1003994484 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS FNP |
| License Number: | 16044197 |
| Business Practice Address: | 301 S Fenway St Ste 202 Casper, WY - 826013053 |
| Business Phone Number: | 3075777737 |
| Business Fax Number: | 3075770049 |
| Mailing Address: | 301 S Fenway St Ste 202, CASPER |
| State: | WY |
| Postal Code: | 826013053 |
| Phone Number: | 3075777737 |
| Fax Number: | 3075770049 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 06/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 16044197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |