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General NPI Number Information
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NPI Number | 1942261680
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Entity Type | Individual
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Provider Name | EILEEN BREEN APRN BC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 205 ALMA ST TUTWILER CLINIC
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City | TUTWILER
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State | MS
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Zip | 38913-0297
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Country | US
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Telephone | 662-345-8331
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Fax | 662-345-8336
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | TUTWILER
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State | MS
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Zip | 38963-0297
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Country | US
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Telephone | 662-345-6217
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Fax | 662-345-8336
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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 | R767376
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License Number State | MS
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