Individual
MR. BARRY ELLIS BRECKLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MSN, FNP-BC
Contact information
Practice address
1 JEFFERSON BARRACKS DR, 11G-JB, SAINT LOUIS, MO 63125-4181
(314) 845-5054
(314) 845-5092
Mailing address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 845-5054
(314) 845-5092
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5862
MN
Other
Enumeration date
04/03/2006
Last updated
12/17/2020
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