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Individual

TIMOTHY GERALD BREAUX JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2021 PERDIDO ST, NEW ORLEANS, LA 70112-1352
(504) 903-3370
Mailing address
744 W MICHIGAN AVE, JACKSON, MI 49201-1909
(800) 242-1131
(517) 787-4146

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
AP04031
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN085125
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1153401
LA
Enumeration date
05/20/2006
Last updated
09/13/2007
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