Healthcare Provider Details

I. General information

NPI: 1063378719
Provider Name (Legal Business Name): BREEZWAY HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 W TROY ST STE B
DOTHAN AL
36303-4455
US

IV. Provider business mailing address

212 W TROY ST STE B
DOTHAN AL
36303-4455
US

V. Phone/Fax

Practice location:
  • Phone: 334-595-9104
  • Fax: 334-387-9184
Mailing address:
  • Phone: 334-595-9104
  • Fax: 334-387-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA LASHA HODGE
Title or Position: FAMILY NURSE PRACTITIONER
Credential: FNP-C
Phone: 334-594-9104