STEPHEN DANIEL BREISACH (NPI# 1437773884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437773884 |
| Entity Type | Individual |
| Full Name | STEPHEN DANIEL BREISACH |
| Practice Address |
2817 Reilly St Fort Bragg NC 28310-7394 |
| Mailing Address |
2817 Reilly St Fort Bragg NC 28310-7301 |
| Practice Telephone | 9109078246 |
| Practice Fax Number | 9109076870 |
| Mailing Telephone | 9109078246 |
| Mailing Fax Number | 9109076870 |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-06-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2817 REILLY ST |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-7394 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225022874 | Victoria Hoang-mai O'shea | Pharmacist | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2005-09-09 |
| 1831799063 | Samantha Macchio | Optometrist | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-10-27 |
| 1548869126 | Carolyn Smith | Registered Nurse | 2817 Reilly St, Fort Bragg, NC 28310-7301 | 2020-10-23 |
| 1114534666 | Lister Hokanson | Pharmacist | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-09-29 |
| 1689289118 | Joseph Stephen Wise | Physical Therapist | 2817 Reilly St, Fort Bragg, NC 28310-7394 | 2020-09-11 |
| 1063027779 | James Pennington Mundy Jr. | Pharmacist | 2817 Reilly St, Fort Bragg, NC 28310-7394 | 2020-09-10 |
| 1548873003 | James Coleman V | Nurse Anesthetist, Certified Registered | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-08-25 |
| 1740893171 | Thomas William Woodroof | Nurse Anesthetist, Certified Registered | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-08-25 |
| 1740892389 | Roger Wayne Webb | Nurse Anesthetist, Certified Registered | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-08-17 |
| 1144838517 | Josephine Kariuki | Family Medicine | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1750552832 | Roger Williams | Student in an Organized Health Care Education/Training Program | Womack Area Medical Center, Family Medical Residency Center, Bldg 4-2817, Fort Bragg, NC 28310-5000 | 2008-03-18 |
| 1255955605 | Elisabeth May Potts | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road, Fort Bragg, NC 28310-7301 | 2020-06-02 |
| 1891319240 | Anne Brezovec | Student in an Organized Health Care Education/Training Program | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-06-02 |
| 1184248577 | Steven Alex Calder | Student in an Organized Health Care Education/Training Program | 2817 Reilly St, Fort Bragg, NC 28310-7394 | 2020-06-02 |
| 1184248510 | Quang Luu Gonzalez | Student in an Organized Health Care Education/Training Program | 2817 Reilly St, Fort Bragg, NC 28310-7394 | 2020-06-01 |
| 1104440643 | Michael Jeremy Lawson | Student in an Organized Health Care Education/Training Program | 2817 Reilly St, Fort Bragg, NC 28310-7301 | 2020-06-01 |
| 1891319224 | Samuel Joseph Strobel | Student in an Organized Health Care Education/Training Program | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-06-01 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
Please comment or provide details below to improve the information on STEPHEN DANIEL BREISACH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.