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NPI Code Detail

MEDICARE: BREANNA SHENK NP

MEDICARE: BREANNA SHENK NP
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
1363LF0000XFamily Nurse PractitionerAPRN11047600FL
2363LF0000XFamily Nurse PractitionerC-APN.0103961-C-NPCO
3363LF0000XFamily Nurse Practitioner89569NM
4363LF0000XFamily Nurse Practitioner5920HI
5363LF0000XFamily Nurse PractitionerAPTP.N3.70128426WA
6363LF0000XFamily Nurse Practitioner3-002972AL
7363LF0000XFamily Nurse Practitioner71018113AIN
8363LF0000XFamily Nurse PractitionerLG-0013905DE
9363LF0000XFamily Nurse Practitioner0024197417VA
10363LF0000XFamily Nurse Practitioner231532LA
11363LF0000XFamily Nurse PractitionerA190652IA
12363LF0000XFamily Nurse Practitioner116866NE
13363LF0000XFamily Nurse Practitioner906040MS

General Provider Information

NPI Number : 1659051621
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA SHENK NP
Provider Business Mailing Address
First Line : 2798 PASS RD
Second Line :
City : BILOXI
State : MS
Zip : 39531-2626
Country : US
Telephone Number : 720-556-0599
Fax Number :
Provider Business Practice Location Address
First Line : 232 MARKET ST
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-3339
Country : US
Telephone Number : 866-849-0692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2023
Last Update Date : 05/26/2026

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