Individual
BRIEANNA M HAROLDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 PATRIOT DR, LITTLE CHUTE, WI 54140-1184
(920) 687-2800
Mailing address
200 PATRIOT DR, LITTLE CHUTE, WI 54140-1184
(920) 687-2800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2364
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750520383
—
WI
Enumeration date
02/04/2009
Last updated
11/08/2012
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