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General NPI Number Information
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NPI Number | 1255816419
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Entity Type | Individual
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Provider Name | BREANNA MUNIZ APRN
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Gender | Female
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 22223 W 66TH ST
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City | SHAWNEE
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State | KS
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Zip | 66226-3522
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Country | US
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Telephone | 913-224-0030
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Fax | 844-900-1292
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Provider Business Mailing Address
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Address Line | 8225 RAVENSWOOD LN
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City | DE SOTO
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State | KS
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Zip | 66018-9633
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Country | US
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Telephone | 785-393-3937
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-78396-062
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License Number State | KS
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