Provider Demographics
NPI:1659433886
Name:HAUSKINS-MCELGUNN, BREANA LEA (ND)
Entity Type:Individual
Prefix:DR
First Name:BREANA
Middle Name:LEA
Last Name:HAUSKINS-MCELGUNN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 N 22ND AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-3153
Mailing Address - Country:US
Mailing Address - Phone:406-587-0858
Mailing Address - Fax:406-586-0406
Practice Address - Street 1:2002 N 22ND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3153
Practice Address - Country:US
Practice Address - Phone:406-587-0858
Practice Address - Fax:406-586-0406
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT68175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath