MEDICARE: BREONA MASSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula		MO

General Provider Information

NPI Number	:	1457201287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREONA MASSEY

Provider Business Mailing Address
First Line	:	1933 W OLD PLANK VILLAGE DR
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-9078
Country	:	US
Telephone Number	:	660-441-8838
Fax Number	:

Provider Business Practice Location Address
First Line	:	1933 W OLD PLANK VILLAGE DR
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-9078
Country	:	US
Telephone Number	:	660-441-8838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2026
Last Update Date	:	01/31/2026

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Directions to “ BREONA MASSEY ” Practice Location

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