Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | 51885 | NE |
NPI | 1467472936 |
---|---|
Provider Name | Miss Tonette L Breckenridge |
First Address | Omaha, NE 68111-1741 |
Second Address | Omaha, NE 68111-1741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |