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Individual

MARTHA ANN BRECKENRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
423 W WHEATLAND RD STE 103, DUNCANVILLE, TX 75116-4630
(469) 567-1234
(972) 709-4600
Mailing address
PO BOX 346, DESOTO, TX 75123-0346
(214) 724-3723
(972) 709-4600

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
363LW0102X
Women's Health Nurse Practitioner
Primary
242859
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
188180701
TX
Enumeration date
12/06/2006
Last updated
10/20/2023
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