Doctor Name: | MRS. LAURA J HARE |
NPI Number: | 1114086584 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | C.R.N.P. |
License Number: | R737881 |
Business Practice Address: | 500 Russell St Suite 3 Starkville, MS - 397593413 |
Business Phone Number: | 6623242244 |
Business Fax Number: | 6623242295 |
Mailing Address: | 500 Russell Street,, Suite 3 STARKVILLE |
State: | MS |
Postal Code: | 397593613 |
Phone Number: | 6623242244 |
Fax Number: | 6623242295 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 04/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R737881 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |