Individual
BREANA MARIE MATZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, ARNP
Contact information
Practice address
1658 ST VINCENTS WAY, SUITE 130, MIDDLEBURG, FL 32068-8446
(904) 264-1628
(904) 264-8386
Mailing address
1658 ST VINCENTS WAY, SUITE 130, MIDDLEBURG, FL 32068-8446
(904) 264-1628
(904) 264-8386
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9287898
FL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
ARNP9287898
FL
367A00000X
Advanced Practice Midwife
Primary
ARNP9287898
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004589600
—
FL
01
—
Y09YP
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/11/2012
Last updated
03/29/2016
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