Healthcare Provider Details

I. General information

NPI: 1386624302
Provider Name (Legal Business Name): DEANNA HALLER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3493 S MERCY RD
GILBERT AZ
85297-0434
US

IV. Provider business mailing address

3493 S MERCY RD
GILBERT AZ
85297-0434
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-5437
  • Fax: 520-874-7070
Mailing address:
  • Phone: 480-827-5042
  • Fax: 480-827-5096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number3022
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: