Healthcare Provider Details

I. General information

NPI: 1609081207
Provider Name (Legal Business Name): VERONICA S HAGGERTY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 LAKEVIEW DR
NEW HOPE PA
18938-2234
US

IV. Provider business mailing address

126 LAKEVIEW DR
NEW HOPE PA
18938-2234
US

V. Phone/Fax

Practice location:
  • Phone: 215-803-8816
  • Fax: 215-862-7288
Mailing address:
  • Phone: 215-803-8816
  • Fax: 215-862-7288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberRN326370L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: