Individual
DR. BREANNE NICOLE VERGONET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 PURPLE HEART AVE, DOVER AFB, DE 19902-5051
(302) 346-8702
Mailing address
115 PURPLE HEART AVE, DOVER AFB, DE 19902-5051
(302) 346-8702
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
0101271622
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0101271622
VA
208D00000X
General Practice Physician
0101271622
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2019
Last updated
10/20/2025
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