Individual
ANGIE S HARAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
971 LAKELAND DR, SUITE 657, JACKSON, MS 39216-4643
(601) 200-5955
(601) 200-5957
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R862590
MS
Other
Enumeration date
09/26/2006
Last updated
05/05/2016
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