Individual
JACQUELYN BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
Mailing address
1208 S 19TH ST, CHICKASHA, OK 73018-3812
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
106676
OK
Other
Enumeration date
01/20/2017
Last updated
08/28/2025
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