Provider Demographics
NPI:1154351864
Name:HARGETT, RITA ANN (FNP)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:ANN
Last Name:HARGETT
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 EARL FRYE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-5507
Mailing Address - Country:US
Mailing Address - Phone:662-256-9331
Mailing Address - Fax:662-597-6005
Practice Address - Street 1:900 EARL FRYE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-5507
Practice Address - Country:US
Practice Address - Phone:662-256-9331
Practice Address - Fax:662-597-6005
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSR764315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00119166Medicaid
MS01984793Medicaid
MS500003562Medicare PIN
MS01984793Medicaid