Southall, Abigail Hagan
Southall, Abigail Hagan is an sole proprietor health care provider with primary practice located at 312 W High St , Lebanon KY 40033-1428. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Southall, Abigail Hagan can be contacted via phone (270) 692-9559.Contact Information
Primary practice address
312 W High St
Lebanon KY 40033-1428
Phone: (270) 692-9559
Fax: (270) 692-9236
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 3015055 | Kentucky |
Profile Details
| NPI number | 1861006066 |
|---|---|
| LBN Legal business name | Southall, Abigail Hagan |
| Credentials | NURSE PRACTITIONER |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 4th, 2020 |
| Last updated | Sep 4th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861006066 | NPPES |
| Kentucky | Other | 3015055 | NURSE PRACTITIONER LICENSE |
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