Provider Demographics
NPI:1689803439
Name:BREINER, VICTORIA LYNN (CNM)
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:LYNN
Last Name:BREINER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 KRYLON DR.
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3737
Mailing Address - Country:US
Mailing Address - Phone:513-733-3237
Mailing Address - Fax:
Practice Address - Street 1:130 KATE IRELAND DR
Practice Address - Street 2:
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749-9071
Practice Address - Country:US
Practice Address - Phone:606-672-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6070367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife