Healthcare Provider Details

I. General information

NPI: 1538924691
Provider Name (Legal Business Name): JOSEPH HARALSON DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BLAKE BLVD
PINEHURST NC
28374-8474
US

IV. Provider business mailing address

300 BLAKE BLVD
PINEHURST NC
28374-8474
US

V. Phone/Fax

Practice location:
  • Phone: 931-338-4167
  • Fax:
Mailing address:
  • Phone: 910-295-6158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5021056
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number5021056
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number305433
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: