Provider Demographics
NPI:1538873062
Name:HAIGH, BREANNA (PA-C)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:HAIGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 N CAUSEWAY
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-5303
Mailing Address - Country:US
Mailing Address - Phone:386-424-8440
Mailing Address - Fax:
Practice Address - Street 1:161 N CAUSEWAY
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169-5303
Practice Address - Country:US
Practice Address - Phone:386-424-8440
Practice Address - Fax:386-426-8839
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical