Healthcare Provider Details

I. General information

NPI: 1245786078
Provider Name (Legal Business Name): LINDSAY MARIE HAGERMAN RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 BRADLEY DRIVE
ASHLAND KY
41101
US

IV. Provider business mailing address

2413 BRADLEY DR
ASHLAND KY
41101-6355
US

V. Phone/Fax

Practice location:
  • Phone: 606-922-8309
  • Fax:
Mailing address:
  • Phone: 606-922-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number6445
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: