Doctor Name: | DESIREE BROOKE HAUGH |
NPI Number: | 1275943086 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | R881909 |
Business Practice Address: | 1970 Hospital Dr Clarksdale, MS - 386147202 |
Business Phone Number: | 6626273211 |
Business Fax Number: | |
Mailing Address: | 343 County Road 8021, RIENZI |
State: | MS |
Postal Code: | 388659300 |
Phone Number: | 6627206800 |
Fax Number: | |
NPI Enumeration Date: | 05/01/2014 |
NPI Last Update Date: | 05/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R881909 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |