Provider Demographics
NPI:1386987634
Name:BREEDEN, MEGAN L (APRN, MSN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:BREEDEN
Suffix:
Gender:F
Credentials:APRN, MSN, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:915 S GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3205
Mailing Address - Country:US
Mailing Address - Phone:931-548-8090
Mailing Address - Fax:931-548-8110
Practice Address - Street 1:915 S GARDEN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401
Practice Address - Country:US
Practice Address - Phone:931-548-8090
Practice Address - Fax:931-548-8110
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17032363LP0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care