Provider Demographics
NPI:1255571998
Name:BREITKREITZ, CAROLE MENZEL (NP)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:MENZEL
Last Name:BREITKREITZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67537
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-8009
Mailing Address - Country:US
Mailing Address - Phone:302-400-9999
Mailing Address - Fax:302-267-4001
Practice Address - Street 1:200 BANNING ST
Practice Address - Street 2:STE 170
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3485
Practice Address - Country:US
Practice Address - Phone:302-400-9999
Practice Address - Fax:302-487-1167
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000484363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner