Petroff, Glenda Carol Breakfell
Petroff, Glenda Carol Breakfell is an sole proprietor health care provider with primary practice located at 22070 Highway 59 , Abita Springs LA 70420. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Petroff, Glenda Carol Breakfell can be contacted via phone (985) 892-0879.Contact Information
Primary practice address
22070 Highway 59
Abita Springs LA 70420
Phone: (985) 892-0879
Fax: (985) 875-2384
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN099641 | Louisiana |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | RN099641AP03834 | Louisiana |
Profile Details
NPI number | 1609879659 |
---|---|
LBN Legal business name | Petroff, Glenda Carol Breakfell |
Credentials | FNPC |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 23rd, 2005 |
Last updated | Jan 28th, 2008 - about 17 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1609879659 | NPPES |
Louisiana | MEDICAID | 1128139 | |
Louisiana | Other | P00239061 | |
Louisiana | MEDICAID | 07931777 |
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