Healthcare Provider Details

I. General information

NPI: 1073165288
Provider Name (Legal Business Name): CHRISTINE HAGGERTY REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GEISINGER WOMEN'S HEALTH OBGYN CLINIC 521 MOUNT PLEASANT DRIVE, 2ND FLOOR
SCRANTON PA
18503
US

IV. Provider business mailing address

GESINGER WOMEN'S HEALTH OBGYN CLINIC 531 MOUNT PLEASANT DRIVE, 2ND FLOOR
SCRANTON PA
18503
US

V. Phone/Fax

Practice location:
  • Phone: 570-703-2135
  • Fax: 570-703-2082
Mailing address:
  • Phone: 570-703-2135
  • Fax: 570-703-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN530716L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: