Provider Demographics
NPI:1376861062
Name:BREESE, JOAN E (RN)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:E
Last Name:BREESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUKE CENTER
Mailing Address - State:PA
Mailing Address - Zip Code:16729-9739
Mailing Address - Country:US
Mailing Address - Phone:814-966-3769
Mailing Address - Fax:
Practice Address - Street 1:645 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUKE CENTER
Practice Address - State:PA
Practice Address - Zip Code:16729-9739
Practice Address - Country:US
Practice Address - Phone:814-966-3769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN322358L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse