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General NPI Number Information
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NPI Number | 1235615188
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Entity Type | Individual
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Provider Name | CARISA BREAKFIELD CPM, LM, DSM, DNM
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Gender | Female
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 406 S LEA AVE
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City | ROSWELL
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State | NM
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Zip | 88203-4564
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Country | US
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Telephone | 601-341-5835
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Fax |
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Provider Business Mailing Address
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Address Line | 634 MOUNT CARMEL CHURCH RD
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City | FOXWORTH
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State | MS
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Zip | 39483-4020
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Country | US
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Telephone | 601-341-5835
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 335283
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 341549
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 332149
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 24003R
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License Number State | NM
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