Individual
BREANNA LEIGH DOENITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
140609
KS
363LP0200X
Pediatric Nurse Practitioner
Primary
26NJ01231600
NJ
363LP0200X
Pediatric Nurse Practitioner
TMP-158957
KS
Other
Enumeration date
09/18/2019
Last updated
02/24/2023
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