NPI 1326097767 · live from the CMS NPI Registry
Keith J Breasure, MSN,NP
Nurse Practitioner, Family in Berlin, VT. National Provider Identifier 1326097767, active.
NPI record
| NPI | 1326097767 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 130 Fisher Rd, Berlin, VT 05602 |
| Practice phone | 802-371-4316 |
| Mailing address | Po Box 547, Att: Cvmc Finance Dept, Barre, VT 05641 |
| Enumerated | May 10, 2006 |
| Last updated | February 12, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | LG0000383 (DE) |
| Nurse Practitioner, Family primary | 363LF0000X | 101.0096152 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.