Provider Demographics
NPI:1225340953
Name:HAGGERTON, CYNTHIA NICOLE (LM)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:NICOLE
Last Name:HAGGERTON
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 HARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3190
Mailing Address - Country:US
Mailing Address - Phone:469-688-1982
Mailing Address - Fax:817-428-9451
Practice Address - Street 1:1813 HARWOOD CT
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3190
Practice Address - Country:US
Practice Address - Phone:469-688-1982
Practice Address - Fax:817-428-9451
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99097176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife