Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0101269664 | VA |
Y | 208600000X | Surgeon | 0101269664 | VA |
N | 208200000X | Surgeon | R9768 | TX |
N | 208600000X | Surgeon | R9768 | TX |
NPI | 1003216714 |
---|---|
Provider Name | Ashleigh Lauren Rapp Hagaman |
First Address | Mechanicsville, VA 23116 |
Second Address | Mechanicsville, VA 23116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2014 |
Last Update Date | 28/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003216714 | (05) | NJ |