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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RYLEE HACKWORTH, PA

Active

RYLEE HACKWORTH, PA is a Medical Physician Assistant healthcare provider located in LAGRANGE, Indiana. NPI 1063104719 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · LAGRANGE, IN

Registration Details

NPI Number
1063104719
Provider Type
Individual
Gender
Female
NPI Issued
May 22, 2023 (3.2298265971074 yrs)
Last Updated
Jan 9, 2025
License
10004694A (IN)

Practice Information

Address
2500 N DETROIT ST
LAGRANGE, IN, 467611158
Browse IN providers · Browse ZIP 46761
Phone
2604632133
Fax
2604633775
Primary Specialty
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.