Provider Demographics
NPI:1558414094
Name:BREEDING, BRENDA K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:K
Last Name:BREEDING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:BRENDA
Other - Middle Name:K
Other - Last Name:PORTENIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:450 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2303
Mailing Address - Country:US
Mailing Address - Phone:402-941-7100
Mailing Address - Fax:402-727-3517
Practice Address - Street 1:450 E 23RD ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2303
Practice Address - Country:US
Practice Address - Phone:402-941-7100
Practice Address - Fax:402-727-3517
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE123261835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric