Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 98-00887 | NC |
N | 207U00000X | Nuclear Medicine Specialist | G86720 | CA |
N | 207U00000X | Nuclear Medicine Specialist | L3672 | TX |
N | 207U00000X | Nuclear Medicine Specialist | MED101722 | MO |
NPI | 1265415830 |
---|---|
Provider Name | Dr. Rosalie Jane Hagge |
First Address | Sacramento, CA 95817-2307 |
Second Address | Sacramento, CA 95817-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G867200 | (05) | CA |
G70979 | (02) |