Provider Demographics
NPI:1760649115
Name:BRETT RICHARD HAARMANN PA-C PLLC
Entity Type:Organization
Organization Name:BRETT RICHARD HAARMANN PA-C PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAARMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-521-2056
Mailing Address - Street 1:5634 W CAVEDALE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-6370
Mailing Address - Country:US
Mailing Address - Phone:623-825-5611
Mailing Address - Fax:623-825-5611
Practice Address - Street 1:5634 W CAVEDALE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85083-6370
Practice Address - Country:US
Practice Address - Phone:623-825-5611
Practice Address - Fax:623-825-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2941363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty