MEDICARE: MS. BARBARA ANN BRECKENRIDGE LPN

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	164W00000X	Licensed Practical Nurse	055585	OH
2	164W00000X	Licensed Practical Nurse	PN055585	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558534180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA ANN BRECKENRIDGE LPN

Provider Business Mailing Address
First Line	:	1879 WATERBROOK LN
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-3334
Country	:	US
Telephone Number	:	614-238-3304
Fax Number	:

Provider Business Practice Location Address
First Line	:	1879 WATERBROOK LN
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-3334
Country	:	US
Telephone Number	:	614-238-3304
Fax Number	:

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

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	05/15/2008

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