Provider Demographics
NPI:1699079277
Name:HAGY, REBECCA ANN (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:HAGY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SUE ST
Mailing Address - Street 2:
Mailing Address - City:GATE CITY
Mailing Address - State:VA
Mailing Address - Zip Code:24251-2721
Mailing Address - Country:US
Mailing Address - Phone:276-386-2783
Mailing Address - Fax:
Practice Address - Street 1:145 SUE ST
Practice Address - Street 2:
Practice Address - City:GATE CITY
Practice Address - State:VA
Practice Address - Zip Code:24251-2721
Practice Address - Country:US
Practice Address - Phone:276-386-2783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001196749163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice