Provider Demographics
NPI:1730074162
Name:HAGAR, LESLIE
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:HAGAR
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 1:3155 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-9021
Mailing Address - Country:US
Mailing Address - Phone:740-683-6107
Mailing Address - Fax:
Practice Address - Street 1:3155 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-9021
Practice Address - Country:US
Practice Address - Phone:740-683-6107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker