Provider Demographics
NPI:1942526496
Name:HAAN, ANDREA GAIL (DC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:GAIL
Last Name:HAAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:GAIL
Other - Last Name:RAMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1000 BRADY ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-5214
Mailing Address - Country:US
Mailing Address - Phone:563-884-5800
Mailing Address - Fax:563-884-5470
Practice Address - Street 1:1000 BRADY ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5214
Practice Address - Country:US
Practice Address - Phone:563-884-5800
Practice Address - Fax:563-884-5470
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO6059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor