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General NPI Number Information
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NPI Number | 1801294830
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Entity Type | Individual
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Provider Name | ALECIA BREAKFIELD CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 1100 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2029
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Country | US
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Telephone | 417-256-9111
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Fax | 417-257-5838
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Provider Business Mailing Address
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Address Line | 1100 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2029
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Country | US
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Telephone | 417-256-9111
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Fax | 417-257-5838
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28219369
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28219369A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R878783
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2016029498
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License Number State | MO
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