Individual provider · Type 1 NPI

Jacklyn Hagg, AGACNP

Nurse Practitioner · Idaho Falls, ID

NPI number 1861928111 Active

Practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Call (208) 529-6111 Map

Fax (208) 529-7021

Mailing address

PO Box 277381
Atlanta, GA 30384-7381

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner 363LA2100XAP 60730619 (WA)
Nurse Practitioner Primary 363L00000X66593 (ID)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1861928111

Jacklyn Hagg, AGACNP's National Provider Identifier is 1861928111, issued on May 5, 2017. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Idaho Falls, ID. The record was last updated on Jun 17, 2021.