Provider Demographics
NPI:1124025549
Name:HAEHNER, BARBARA DIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:DIANE
Last Name:HAEHNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 PENN ST
Mailing Address - Street 2:P.O. BOX 478
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-9460
Mailing Address - Country:US
Mailing Address - Phone:317-804-5782
Mailing Address - Fax:317-804-5783
Practice Address - Street 1:202 PENN ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-9460
Practice Address - Country:US
Practice Address - Phone:317-804-5782
Practice Address - Fax:317-804-5783
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038501207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200001850AMedicaid
IN000000083023OtherANTHEM NUMBER
IN200001850AMedicaid
IN200001850AMedicaid