Provider Demographics
NPI:1912762337
Name:BREEN, LAURA CLARK (APRN)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:CLARK
Last Name:BREEN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # A-50
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-6575
Mailing Address - Fax:216-444-5632
Practice Address - Street 1:9500 EUCLID AVE # A-50
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-6575
Practice Address - Fax:216-444-5632
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033817363L00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner