Basic Information
| Provider Information | |||||||||
| NPI: | 1780098871 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARLE | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | NOELLE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GEISELMAN | ||||||||
| OtherFirstName: | BROOKE | ||||||||
| OtherMiddleName: | NOELLE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 730 E 34TH ST | ||||||||
| Address2: | ESSENTIA HEALTH HIBBING CLINIC | ||||||||
| City: | HIBBING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557465109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182631000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 730 E 34TH ST | ||||||||
| Address2: | ESSENTIA HEALTH HIBBING CLINIC | ||||||||
| City: | HIBBING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557465109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182631000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2014 | ||||||||
| LastUpdateDate: | 10/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R179577-0 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.