Breazeale, Dana Theis

Breazeale, Dana Theis is an individual health care provider with primary practice located at 3200 Vine Street , Cincinnati OH 45208. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Breazeale, Dana Theis can be contacted via phone (513) 861-3100.

Contact Information

Primary practice address
3200 Vine Street Cincinnati OH 45208
Phone: (513) 861-3100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN 862 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN268214-COA08862 Ohio

Profile Details

NPI number 1992777932
LBN Legal business name Breazeale, Dana Theis
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992777932 NPPES
South Carolina MEDICAID NP0533

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