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MISTY BREAUX RN

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1831583715

Individual Registrant:
 MISTY  BREAUX RN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
HWY 160/163 BUILDING KA 2010  KAYENTA, AZ 86033 US
Tel: 928-697-4100  Fax: --

Contact information for business:
139 ELK DRIVE  EAGLE BUTTE, SD 57625 US
Tel: 985-518-9432  Fax: --

Registration Information:
NPI: 1831583715
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163W00000XNursing Service Providers
Registered Nurse
SDR045218
N163WE0003XNursing Service Providers
Registered Nurse
SDR045218

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
060012AZ05




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