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General NPI Number Information
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NPI Number | 1023996972
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Entity Type | Individual
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Provider Name | ALYSE CHRISTINE HAGGERTY RN
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 5515 PEACH ST
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City | ERIE
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State | PA
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Zip | 16509-2603
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Country | US
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Telephone | 814-864-4031
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Fax |
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Provider Business Mailing Address
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Address Line | 3413 HAMPSHIRE RD
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City | ERIE
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State | PA
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Zip | 16506-3319
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Country | US
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Telephone | 814-823-5838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN709228
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License Number State | PA
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