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Individual

MRS. HAILEY A BRACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
9201 W THOMAS RD, PHOENIX, AZ 85037-3332
(623) 327-4000
Mailing address
4235 N 16TH AVE, PHOENIX, AZ 85015-4716
(928) 446-5664

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
279177
AZ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/10/2019
Last updated
08/10/2022
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