Individual
UNDRA L HAGGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1202 DESOTO AVE, CLARKSDALE, MS 38614-6937
(662) 202-1297
Mailing address
619 S STATE ST, CLARKSDALE, MS 38614-6319
(662) 645-4827
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
903148
MS
Other
Enumeration date
02/08/2019
Last updated
06/07/2019
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