Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 0102206138 | VA |
N | 208000000X | Pediatrician | OT017681 | PA |
NPI | 1265961916 |
---|---|
Provider Name | Ashley Elizabeth Griswold Haggerty |
First Address | Richmond, VA 23298 |
Second Address | Richmond, VA 23298-5023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2017 |
Last Update Date | 04/08/2021 |