Angie S Haraway, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R862590 Issued in MS

Practice address

971 Lakeland Dr
Suite 657
Jackson, MS 39216-4643

Phone

(601) 200-5955

Fax

(601) 200-5957

NPI assigned

Sep 26, 2006

Last updated

May 5, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Dominic Medical Associates LLC

  dba Family Practice Associates

  • Family Medicine Physician
  • Flowood, MS
  • NPI 1710040712
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1790876928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 657",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-200-5955",
            "fax_number": "601-200-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARAWAY",
        "first_name": "ANGIE",
        "middle_name": "S",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R862590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajvinder Singh Hanspal, M.D.
• Sadia Haque
• Susan Russell Haralson, NURSE PRACTITIONER
• Yathish Haralur Sreekantaiah, M.D
• Allen McNeil Haraway, M.D.
• Claude Franklin Harbarger, M.D.
• Harbor Houses of Jackson, Inc. (Harbor House Chemical Dependency Services)
• Jo Luresa Harbour, MD
• Kaleigh Harbour, FLIGHT RN, NRP
• Kyla Nichole Harbuck, DO

• Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.