Provider Demographics
NPI:1790650125
Name:HACKETT GAGNON, LORI JO (RN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:JO
Last Name:HACKETT GAGNON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 STRAFORD CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2117
Mailing Address - Country:US
Mailing Address - Phone:302-373-9796
Mailing Address - Fax:
Practice Address - Street 1:509 STRAFORD CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-2117
Practice Address - Country:US
Practice Address - Phone:302-373-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0040139163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool