Individual
MRS. DANA THEIS BREAZEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3200 VINE STREET, CINCINNATI, OH 45208
(513) 861-3100
Mailing address
1344 CUSTER AVE, CINCINNATI, OH 45208-2525
(513) 699-0833
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APN 862
SC
363LF0000X
Family Nurse Practitioner
Primary
RN268214-COA08862
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0533
—
SC
Enumeration date
02/03/2006
Last updated
07/09/2007
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