Provider Demographics
NPI:1073165288
Name:HAGGERTY, CHRISTINE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:HAGGERTY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GESINGER WOMEN'S HEALTH OBGYN CLINIC
Mailing Address - Street 2:531 MOUNT PLEASANT DRIVE, 2ND FLOOR
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503
Mailing Address - Country:US
Mailing Address - Phone:570-703-2135
Mailing Address - Fax:570-703-2082
Practice Address - Street 1:GEISINGER WOMEN'S HEALTH OBGYN CLINIC
Practice Address - Street 2:521 MOUNT PLEASANT DRIVE, 2ND FLOOR
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503
Practice Address - Country:US
Practice Address - Phone:570-703-2135
Practice Address - Fax:570-703-2082
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN530716L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse