Provider Demographics
NPI:1477056588
Name:MORIARTY, BREANNE HELENA (CD(DONA))
Entity Type:Individual
Prefix:
First Name:BREANNE
Middle Name:HELENA
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 W FAIRMONT DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-3632
Mailing Address - Country:US
Mailing Address - Phone:801-592-8004
Mailing Address - Fax:
Practice Address - Street 1:29 W FAIRMONT DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-3632
Practice Address - Country:US
Practice Address - Phone:801-592-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty