Healthcare Provider Details

I. General information

NPI: 1689803439
Provider Name (Legal Business Name): VICTORIA LYNN BREINER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KATE IRELAND DR
HYDEN KY
41749-9071
US

IV. Provider business mailing address

1722 KRYLON DR.
CINCINNATI OH
45215-3737
US

V. Phone/Fax

Practice location:
  • Phone: 606-672-2901
  • Fax:
Mailing address:
  • Phone: 513-733-3237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number6070
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: