Mary Kathryn Haggard, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17870 Issued in CA

Practice address

2510 Douglas Blvd Ste 200
Roseville, CA 95661-3301

Phone

(916) 773-1191

Fax

(916) 773-0498

NPI assigned

Jan 17, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Molly Haggard Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mobile Medical & Nursing, Inc.

  • Nurse Practitioner
  • Palm Beach Gardens, FL
  • NPI 1023123940
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144406380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 DOUGLAS BLVD STE 200",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613301",
            "telephone_number": "916-773-1191",
            "fax_number": "916-773-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 DOUGLAS BLVD STE 200",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613301",
            "telephone_number": "916-773-1191",
            "fax_number": "916-773-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGARD",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "RN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "468668",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "17870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRN/NURSE PRACTITIONER",
            "identifier": "17870",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRN/REGISTERED NURSE",
            "identifier": "468668",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "HAGGARD",
            "credential": "RN, FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Saffron Ruth Hackett, RN, MSN, NM, FNP-C
• Sara Hadj-Bahramiyan
• Deborah Hadley
• Hafez and Ghoneim Dental Corp
• David Shane Hagemann, PA
• Melanie Anne Haggard, PHARM.D.
• Cheryl Diane Haggerty, PHARM.D.
• Patrick Ryan Haggerty
• Garrett Hagwood, MD
• Jennifer Ann Hahn, B.A.

• Family Nurse Practitioner in Roseville, CA
• Providers in Roseville, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.