Healthcare Provider Details

I. General information

NPI: 1497610257
Provider Name (Legal Business Name): BREANN NAOMI LU HARPOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 ASBURY RD STE 8
DUBUQUE IA
52002-0483
US

IV. Provider business mailing address

2855 ASBURY RD STE 8
DUBUQUE IA
52001-2910
US

V. Phone/Fax

Practice location:
  • Phone: 563-334-2033
  • Fax:
Mailing address:
  • Phone: 563-334-2033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number120224
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: