Provider Demographics
NPI:1629341649
Name:HARRINGTON, AMY L (NP-C)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:L
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:GRUBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5003 HARDY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1331
Mailing Address - Country:US
Mailing Address - Phone:601-261-5700
Mailing Address - Fax:601-261-5777
Practice Address - Street 1:5003 HARDY ST STE 200
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1331
Practice Address - Country:US
Practice Address - Phone:601-261-5700
Practice Address - Fax:601-261-5777
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR860597363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner