UNDRA L HAGGAN (NPI# 1144785684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144785684 |
| Entity Type | Individual |
| Full Name | UNDRA L HAGGAN |
| Credential | NURSE PRACTITIONER |
| Practice Address |
1202 Desoto Ave Clarksdale MS 38614-6937 |
| Mailing Address |
619 S State St Clarksdale MS 38614-6319 |
| Practice Telephone | 6622021297 |
| Mailing Telephone | 6626454827 |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
903148 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1202 Desoto Ave, Clarksdale, MS 386146937 | 6622021297 |
| Street Address |
1202 DESOTO AVE |
| City | CLARKSDALE |
| State | MS |
| Zip Code | 38614-6937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1982140448 | A Healthy You Medical Clinic, 'l.l.c.' | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614-6937 | 2017-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1700226123 | Nikki Nikkia Cager | Internal Medicine | 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 | 2013-06-29 |
| 1205186947 | Celestial Comfort Care Hospice | Hospice Care, Community Based | 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 | 2012-09-10 |
| 1063667129 | The Smile Center of Clarksdale | Clinic/Center | 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 | 2008-11-17 |
| 1801060033 | Clarksdale Municipal School District | Local Education Agency (LEA) | Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 | 2008-04-18 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1114040367 | William F Wilson Jr. | Dentist | 850 Desoto Ave, Extended, Clarksdale, MS 38614 | 2007-04-10 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| 1497888457 | Carole L Mangrem | Pediatrics | 2245 N Starte St, Clarksdale, MS 38614 | 2007-03-13 |
| 1811050313 | Long Family Dentistry Inc | Dentist | 527 Desoto Avenue, Clarksdale, MS 38614 | 2006-12-18 |
| Find all providers in zip 38614 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493275 | Destemona Bozhani-marte | Nurse Practitioner | 5804 Sw Bray Rd, Clarksdale, MO 64430-9176 | 2020-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143024 | Desoto Family Wellness Center, LLC | Nurse Practitioner | 3495 Cobblestone Blvd South, Southaven, MS 38672-3867 | 2020-10-30 |
| 1760096127 | Sarah Freeman Adams | Nurse Practitioner | 710 Ms -371, Mooreville, MS 38857 | 2020-09-03 |
| 1295353290 | Ashley Smith Allen | Nurse Practitioner | Rankin Rural Medical Center, 129 Center Street Suite B, Richland, MS 39218 | 2020-07-07 |
| 1619591542 | Kristy S. Franks | Nurse Practitioner | 2803 Cobb Stump Rd, Fulton, MS 38843-7391 | 2020-06-06 |
| 1013543388 | Mallory Elizabeth Boggs | Nurse Practitioner | 159 Fountains Blvd Ste B, Madison, MS 39110-6344 | 2020-03-19 |
| 1265072821 | Settlemires Family Medical Clinic, LLC | Nurse Practitioner | 3198 Highway 72 W, Corinth, MS 38834-9303 | 2020-01-13 |
| 1588211916 | Pattye Dorris | Nurse Practitioner | 415 Us Highway 49 N, Tutwiler, MS 38963-5091 | 2019-08-21 |
| 1457907248 | Tanya Sanderson | Nurse Practitioner | 4208 Ridgemont Drive, Belden, MS 38826 | 2019-08-16 |
| 1720556319 | Julie Smythe Harper | Nurse Practitioner | 86 Berry Rd, Newhebron, MS 39140-5496 | 2018-11-13 |
| 1063912046 | Laquania Williams | Nurse Practitioner | 470 County Road 471, Vardaman, MS 38878-9770 | 2018-02-16 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSDALE |
| Zip Code | 38614 |
Please comment or provide details below to improve the information on UNDRA L HAGGAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.