NPI 1043484371 · live from the CMS NPI Registry
Michelle Lynn Breneman, PNP
Nurse Practitioner, Pediatrics in Lake Saint Louis, MO. National Provider Identifier 1043484371, active.
NPI record
| NPI | 1043484371 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 100 Brevco Plz, Ste 101, Lake Saint Louis, MO 63367 |
| Practice phone | 636-561-5437 |
| Mailing address | Po Box 7412119, Chicago, IL 60674 |
| Enumerated | April 17, 2008 |
| Last updated | April 18, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 2003020311 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.