Provider Demographics
NPI:1851340541
Name:BREEDING, GINGER (RN)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:BREEDING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:
Other - Last Name:BREEDING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5148B CRACKER JACK LN
Mailing Address - Street 2:
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310-2000
Mailing Address - Country:US
Mailing Address - Phone:760-386-4232
Mailing Address - Fax:
Practice Address - Street 1:US ARMY MEDICAL DEPARTMENT ACTIVITY (MEDDAC)
Practice Address - Street 2:
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310-5065
Practice Address - Country:US
Practice Address - Phone:760-380-3144
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171660163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse