Provider Demographics
NPI:1881136901
Name:HAGGERTY, ALEXANDRA MCCLELLAN (NP)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:MCCLELLAN
Last Name:HAGGERTY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 DOLAN CIR
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1235
Mailing Address - Country:US
Mailing Address - Phone:774-218-9017
Mailing Address - Fax:
Practice Address - Street 1:797 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1623
Practice Address - Country:US
Practice Address - Phone:781-624-5065
Practice Address - Fax:781-624-4428
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289260363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health