Provider Demographics
NPI:1295467264
Name:HAAN, ALICIA R
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:R
Last Name:HAAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 GRANDE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2221
Mailing Address - Country:US
Mailing Address - Phone:254-462-3466
Mailing Address - Fax:
Practice Address - Street 1:1625 GRANDE AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2221
Practice Address - Country:US
Practice Address - Phone:254-462-3466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula