NPI 1235486952 · live from the CMS NPI Registry
Amanda Nicole Breedlove, PNP
Nurse Practitioner, Pediatrics in Fenton, MO. National Provider Identifier 1235486952, active.
NPI record
| NPI | 1235486952 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1203 Smizer Mill Rd, Suite 100, Fenton, MO 63026 |
| Practice phone | 636-717-1414 |
| Mailing address | 1203 Smizer Mill Rd, Fenton, MO 63026 |
| Enumerated | August 13, 2012 |
| Last updated | February 28, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 2012026927 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.