Provider Demographics
NPI:1710597075
Name:ALBRIGHT, BREANNA (APRN)
Entity Type:Individual
Prefix:MS
First Name:BREANNA
Middle Name:
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8594 DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LOU
Mailing Address - State:KY
Mailing Address - Zip Code:40258
Mailing Address - Country:US
Mailing Address - Phone:502-887-8680
Mailing Address - Fax:
Practice Address - Street 1:8594 DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:LOU
Practice Address - State:KY
Practice Address - Zip Code:40258
Practice Address - Country:US
Practice Address - Phone:502-887-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015020363LP2300X, 363LF0000X
KY57174363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care