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General NPI Number Information
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NPI Number | 1295681831
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Entity Type | Organization
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Legal Business Name | JLBREITO EZAIRWAY LLC
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 620 N MAIN ST
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City | HARRISON
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State | AR
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Zip | 72601-2911
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Country | US
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Telephone | 870-414-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 317 BLUE STEM LN
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City | ALEDO
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State | TX
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Zip | 76008-1227
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Country | US
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Telephone | 682-552-8874
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER BREITO
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Credential | APRN-CRNA
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Telephone | 682-552-8874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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