Individual
EILEEN BREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Contact information
Practice address
205 ALMA ST, TUTWILER CLINIC, TUTWILER, MS 38913-0297
(662) 345-8331
(662) 345-8336
Mailing address
PO BOX 297, TUTWILER, MS 38963-0297
(662) 345-6217
(662) 345-8336
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R767376
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114562
—
MS
Enumeration date
03/31/2006
Last updated
12/06/2012
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