Provider Demographics
NPI:1790590222
Name:LEMAR, BREANNE NICOLE (APRN-RNP)
Entity type:Individual
Prefix:MRS
First Name:BREANNE
Middle Name:NICOLE
Last Name:LEMAR
Suffix:
Gender:F
Credentials:APRN-RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10687 S SILVERBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-6555
Mailing Address - Country:US
Mailing Address - Phone:520-449-2478
Mailing Address - Fax:
Practice Address - Street 1:10687 S SILVERBLUFF DR
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-6555
Practice Address - Country:US
Practice Address - Phone:520-449-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ317587363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty