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BREANNA NICOLE LILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
99 TAVERN RD, MARTINSBURG, WV 25401-2890
(304) 263-4999
(304) 263-0984
Mailing address
26005 RIDGE RD STE 200, DAMASCUS, MD 20872-1899
(301) 414-2300
(301) 414-0476

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AC004114
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
93424
WV BOARD OF NURSING
WV
Enumeration date
02/02/2022
Last updated
08/19/2022
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