Individual
DANECA SHONTAYE HAGGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
510 N MAIN ST, EMPORIA, VA 23847-1236
(434) 634-7723
Mailing address
PO BOX 70, 1508 KV ROAD, VICTORIA, VA 23974-0070
(434) 696-2165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024176998
VA
Other
Enumeration date
10/16/2018
Last updated
12/02/2018
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