Individual
JUDY BRESHEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1101
OK
152W00000X
Optometrist
Primary
885
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB1051
RAILROAD MEDICARE GROUP ID
AZ
01
—
P00112635
RAILROAD MEDICARE PIN
AZ
Enumeration date
11/15/2006
Last updated
12/10/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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