| Doctor Name: | MS. MARYLYN A. HAGERTY |
| NPI Number: | 1548558968 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 267941 |
| Business Practice Address: | 26750 Towne Centre Dr Ste A Foothill Ranch, CA - 926102841 |
| Business Phone Number: | 9493051200 |
| Business Fax Number: | 9493058520 |
| Mailing Address: | 1808 Calle Mayita, SAN CLEMENTE |
| State: | CA |
| Postal Code: | 926722306 |
| Phone Number: | 9493612277 |
| Fax Number: | 9493615092 |
| NPI Enumeration Date: | 07/19/2011 |
| NPI Last Update Date: | 10/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 267941 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |