Individual
ANDREA RUTH LAVIGNE-HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13640 STEELECROFT PKWY, CHARLOTTE, NC 28278-7565
(704) 512-5500
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-6443
(330) 493-8677
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13344
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/20/2023
Last updated
03/27/2024
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