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General NPI Number Information
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NPI Number | 1396586004
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Entity Type | Individual
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Provider Name | BREANNA NEIGHBORS
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 1301 SURREY CRES
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City | NORFOLK
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State | VA
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Zip | 23508-1130
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Country | US
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Telephone | 678-294-5506
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 SURREY CRES
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City | NORFOLK
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State | VA
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Zip | 23508-1130
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9480473
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-309571
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License Number State | VA
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