Individual
BRETON BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2316 S CEDAR ST, LANSING, MI 48910-3152
(517) 887-4302
Mailing address
PO BOX 30161, LANSING, MI 48909-7661
(517) 887-4383
(517) 244-7174
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704311303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427441245
—
MI
Enumeration date
03/18/2015
Last updated
07/24/2025
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