Kathleen E Haycraft, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

072208 Issued in MO

Practice address

163 Medical Dr
Hannibal, MO 63401-6884

Phone

(573) 248-3900

NPI assigned

Aug 3, 2006

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

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Riverside Dermatology & Spa LLC

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1699262329
  Medicare reassignment NPD
• Integrated Dermatology of Northeast Missouri LLC

  • Dermatology Physician
  • Hannibal, MO
  • NPI 1992518658
  NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1508874736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016884",
            "telephone_number": "573-719-1818",
            "fax_number": "573-719-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016884",
            "telephone_number": "573-248-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYCRAFT",
        "first_name": "KATHLEEN",
        "middle_name": "E",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "072208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayibu Harruna, MD
• Luke Hart
• Rachel Beth Hart, RPH
• Kaitlyn Hartig, MS, OTR/L
• Keegan Marie Harvey, RNFA
• Dolores Edith Haynes, APRN
• Nancy Marie Hays, R.D., L.D.
• Jennifer Lynn Hazlak Montross, DC
• Healing Hearts Family Counseling LLC
• Healthstat on-Site Clinic Watlow Hannibal Mo

• Nurse Practitioner in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.