MEDICARE: PHILIP ANDREW BREINER CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1-133902	AL

General Provider Information

NPI Number	:	1275046658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP ANDREW BREINER CRNP

Provider Business Mailing Address
First Line	:	2321 HIGHWAY 150
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-3540
Country	:	US
Telephone Number	:	205-989-7254
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 HIGHWAY 150
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-3540
Country	:	US
Telephone Number	:	205-989-7254
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2017
Last Update Date	:	06/29/2023

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