Individual
MS. JENNA ROSE BRETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NPF
Contact information
Practice address
855 SEQUOIA CIR, FORT BRAGG, CA 95437
(707) 964-1251
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
18011
CA
363L00000X
Nurse Practitioner
Primary
18011
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1784
NURSE MIDWIFERY
CA
01
—
18011
NURSE PRACTITIONER FURNISHING
CA
Enumeration date
04/18/2008
Last updated
02/28/2019
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