Provider Demographics
NPI:1588235774
Name:HASPER, CHRISTY BAILEY (AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:BAILEY
Last Name:HASPER
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 COUNTY ROUTE 70A
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-9232
Mailing Address - Country:US
Mailing Address - Phone:607-382-8913
Mailing Address - Fax:
Practice Address - Street 1:2425 JAMES ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-2821
Practice Address - Country:US
Practice Address - Phone:585-465-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310080363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health