Individual
REBECCA HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 MEDICAL VILLAGE DR STE 258, EDGEWOOD, KY 41017-5411
(859) 301-2211
Mailing address
3609 RANBIR DR, DURHAM, NC 27713-1792
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3008994
KY
Other
Enumeration date
07/15/2014
Last updated
10/15/2014
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