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General NPI Number Information
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NPI Number | 1821988528
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Entity Type | Individual
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Provider Name | BREANNA LYNN KADISH
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Gender | Female
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 3401 LUDINGTON ST
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City | ESCANABA
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State | MI
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Zip | 49829-1300
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Country | US
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Telephone | 906-280-2711
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 LUDINGTON ST
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City | ESCANABA
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State | MI
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Zip | 49829-1300
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Country | US
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Telephone | 906-280-2711
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4704344852
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License Number State | MI
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