# BREANNA NICOLE LILLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1659024347
- **Gender:** F
- **Credential:** CNM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | AC004114 | MD | Yes |

## Other

- **Enumeration date:** 02/02/2022
- **Last updated:** 08/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 93424 | WV BOARD OF NURSING | WV |