=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598697807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIANNE MARENE HADDIX BSN, RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2026
-----------------------------------------------------
Last Update Date | 06/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15601 US HIGHWAY 150
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61944-6071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-465-5391
-----------------------------------------------------
Fax | 217-466-1225
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15601 US HIGHWAY 150
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61944-6071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-465-5391
-----------------------------------------------------
Fax | 217-466-1225
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0200X
-----------------------------------------------------
Taxonomy Name | School Registered Nurse
-----------------------------------------------------
License Number | 041489017
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------