Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Jacklyn Hagg, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1861928111

Mrs. Jacklyn Hagg, AGACNP is a Nurse Practitioner in Idaho Falls, Idaho. Qualified in 2016, 10 years ago. Practices with Intensive Care Consortium Inc, a 483-clinician group and accepts Medicare assignment. Licensed in Idaho and Washington.

Years since qualifying
10
Licensed in
ID, WA
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone: (208) 529-6111
Fax: (208) 529-7021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 66593 (ID)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence AP 60730619 (WA)

Record details

NPI number1861928111
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedMay 5, 2017
Last updated in NPPESJune 17, 2021
Certification dateJune 17, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Intensive Care Consortium Inc — 483 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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