Healthcare Provider Details

I. General information

NPI: 1770154809
Provider Name (Legal Business Name): CHRISTY ROE HAGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 NICHOLASVILLE RD
LEXINGTON KY
40503-1463
US

IV. Provider business mailing address

462 WELLINGTON WAY
WINCHESTER KY
40391-8443
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-6100
  • Fax:
Mailing address:
  • Phone: 859-749-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number3016825
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number1131777
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: