Individual
MR. DAN B BRECKENRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1068 CRESTHAVEN RD, SUITE 150, MEMPHIS, TN 38119-0800
(901) 682-6828
(901) 682-9316
Mailing address
PO BOX 172104, MEMPHIS, TN 38187-2104
(901) 682-6828
(901) 682-9316
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN8777
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00116184
MS MEDICAID
MS
01
—
11682
TLC
TN
01
—
117408
BETTER HEALTH
TN
01
—
2040503
UHC
—
01
—
3028383
BLUE CROSS
TN
Enumeration date
08/25/2006
Last updated
09/15/2012
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