| Lanita Breeze, | |
|
1010 College St, Oxford, NC 27565-2507 | |
| (919) 690-3237 | |
| (919) 690-3213 |
| Full Name | Lanita Breeze |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1010 College St, Oxford, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053447920 | NPI | - | NPPES |
| 8051716 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 1540 (North Carolina) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 40175 (North Carolina) | Primary |
| Entity Name | Granville Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275638512 PECOS PAC ID: 1052223757 Enrollment ID: O20040301000909 |
| Mailing Address | Practice Location Address |
|---|---|
| Lanita Breeze, 2301 Erwin Rd, Durham, NC 27705-4699 Ph: () - | Lanita Breeze, 1010 College St, Oxford, NC 27565-2507 Ph: (919) 690-3237 |
Mary Thorp, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1010 College St, Oxford, NC 27565 Phone: 919-690-3237 Fax: 919-690-3213 | |
Pamela Fleming, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1010 College St, Oxford, NC 27565 Phone: 919-690-3000 | |
Peter Tocci, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1010 College St, Oxford, NC 27565 Phone: 919-690-3237 |