Provider Demographics
NPI:1659620102
Name:BREEN, ALEISHA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ALEISHA
Middle Name:ANN
Last Name:BREEN
Suffix:
Gender:F
Credentials:FNP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8111
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-658-3887
Mailing Address - Fax:314-286-8555
Practice Address - Street 1:4455 DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1111
Practice Address - Country:US
Practice Address - Phone:314-658-3887
Practice Address - Fax:314-286-8555
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120149515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily