Individual
BREANNA HAGLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2512 E DUPONT RD STE 200, FORT WAYNE, IN 46825-1609
(260) 748-3650
(260) 748-3651
Mailing address
PO BOX 670, HUNTERTOWN, IN 46748-0670
(260) 748-3650
(260) 748-3650
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002628A
FL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
12/03/2018
Last updated
08/13/2019
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