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General NPI Number Information
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NPI Number | 1245655661
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Entity Type | Individual
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Provider Name | CHARITY BREES NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2014
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 4566 SOUTH EASON BLVD SUITE 310
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City | TUPELO
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State | MS
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Zip | 38801
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Country | US
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Telephone | 601-984-5261
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Fax |
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Provider Business Mailing Address
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Address Line | 504 CLINTON CENTER DRIVE CBO-SUITE 4300
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City | CLINTON
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State | MS
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Zip | 39056
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Country | US
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Telephone | 601-815-2005
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 854946
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License Number State | MS
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