Individual
CARISA HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1008 N MULBERRY ST, ELIZABETHTOWN, KY 42701-2037
(270) 769-0865
(270) 769-0409
Mailing address
1008 N MULBERRY ST, ELIZABETHTOWN, KY 42701-2037
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011070
KY
Other
Enumeration date
08/28/2011
Last updated
08/28/2011
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