Provider Demographics
NPI:1316076169
Name:HAGANS, AIMEE LOUISE
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:LOUISE
Last Name:HAGANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18528 COUNTY ROAD 7
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-9679
Mailing Address - Country:US
Mailing Address - Phone:740-622-2303
Mailing Address - Fax:740-622-2303
Practice Address - Street 1:18528 COUNTY ROAD 7
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-9679
Practice Address - Country:US
Practice Address - Phone:740-622-2303
Practice Address - Fax:740-622-2303
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2557059Medicaid