Provider Demographics
NPI:1104525732
Name:HINOJOSA, BREANAH FAITH (CD-L)
Entity type:Individual
Prefix:
First Name:BREANAH
Middle Name:FAITH
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:CD-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12223 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-2834
Mailing Address - Country:US
Mailing Address - Phone:619-253-5283
Mailing Address - Fax:
Practice Address - Street 1:12223 S 28TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-2834
Practice Address - Country:US
Practice Address - Phone:619-253-5283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula