Rose A Haroldson, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9242 Issued in MN

Practice address

705 Pleasant Ave S
Park Rapids, MN 56470-1440

Phone

(218) 732-2800

Fax

(218) 732-2857

NPI assigned

Jul 25, 2006

Last updated

Dec 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1386667061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROLDSON",
        "first_name": "ROSE",
        "middle_name": "A",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386667061",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "S74322",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Hacker, M.D.
• Dyneen L Hafics, COTA
• Leah Hall, OTR
• Christina Halse
• Lisa A Harmon, MD
• Nathan Phillip Harris, MD
• Healthy Returns of Minnesota Inc
• Heartland Center of Natural Healing, PLLC
• Heartland Lakes Community School
• Stacia Lenore Heisler, FNP

• Physician Assistant in Park Rapids, MN
• Providers in Park Rapids, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.