GLENDA CAROL BREAKFELL PETROFF (NPI# 1609879659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609879659 |
| Entity Type | Individual |
| Full Name | GLENDA CAROL BREAKFELL PETROFF |
| Credential | FNPC |
| Practice Address |
22070 Highway 59 Abita Springs LA 70420 |
| Mailing Address |
1514 Jefferson Hwy New Orleans LA 70121 |
| Practice Telephone | 9858920879 |
| Practice Fax Number | 9858752384 |
| Mailing Telephone | 5048424000 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2008-01-28 |
| NPI Deactivation Date | 05/23/2005 |
| NPI Reactivation Date | 2005-05-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN099641AP03834 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN099641 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07931777 | 05 | |
| LA | 1128139 | 05 | |
| RR MEDICARE | P00239061 | 01 |
| Street Address |
22070 HIGHWAY 59 |
| City | ABITA SPRINGS |
| State | LA |
| Zip Code | 70420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104149731 | Elizabeth Thibodeaux Buras | Nurse Practitioner | 22070 Highway 59, Abita Springs, LA 70420-3606 | 2010-03-10 |
| 1386744704 | Beth Ann Evans | Internal Medicine | 22070 Highway 59, Suite C, Abita Springs, LA 70420-3606 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700630 | Kristin Leonie Mayer Couch | Registered Nurse | 25010 Burvant Street, Abita Springs, LA 70420 | 2020-11-08 |
| 1679174452 | Donna Shartil Golman | Driver | 73350 Birdie Street, Abita Springs, LA 70420 | 2020-11-06 |
| 1528510351 | Simone Delaune Nolan | Counselor | 302 Lei Lani Ave, Abita Springs, LA 70420 | 2016-10-27 |
| 1053660456 | Andrew Wayne Martin Sr. | Radiology | 121 St. Charles Ct., Abita Springs, LA 70420 | 2012-08-31 |
| 1225243157 | Michael Joseph Petrosky | Chiropractor | 71623 Hickory St., Abita Springs, LA 70420 | 2007-05-14 |
| 1477698801 | Steven E Pfingsten | Dentist | 71623 Hickory Street, Abita Springs, LA 70420 | 2007-02-21 |
| 1235464488 | Abita Chiropractic LLC | Chiropractor | 71623 Hickory St., Abita Springs, LA 70420 | 2009-10-06 |
| 1588721179 | Louis P. Nogues, IIi, Dds, A Professional Corp. | Dentist | 22464 Highway 435, Abita Springs, LA 70420-2206 | 2007-01-02 |
| 1982807632 | Nicole Suberville Wascom | Dentist | 22464 Highway 435, Abita Springs, LA 70420-2206 | 2007-06-08 |
| 1396875324 | Eduardo Menendez | Dentist | 22464 Highway 435, Abita Springs, LA 70420-2206 | 2007-03-07 |
| Find all providers in zip 70420 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497369706 | Karla Matthews | Nurse Practitioner | 3710 South Rochenblave St., New Orleans, LA 70125-1003 | 2020-09-03 |
| 1972117455 | Erin Mccabe | Nurse Practitioner | 3712 Tartan Dr, Metairie, LA 70003-1640 | 2020-09-02 |
| 1023620259 | Caroline Hebert | Nurse Practitioner | 1297 Saint Charles St Ste H, Houma, LA 70360-2869 | 2020-08-19 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1124638036 | Kimberly Roshelle Coney | Nurse Practitioner | 62112 Bennett Rd, Roseland, LA 70456-1706 | 2020-08-05 |
| 1356951396 | Advance Clinical Associates LLC | Nurse Practitioner | 2505 Cypress Springs Ave, Ruston, LA 71270-5109 | 2020-08-05 |
| 1487264594 | Neely Primary | Nurse Practitioner | 102 Independence Blvd, Lafayette, LA 70506-6085 | 2020-08-04 |
| 1225648629 | Indria Kendrick | Nurse Practitioner | 62 Creduer Rd, Pineville, LA 71360-9165 | 2020-07-31 |
| 1770192171 | Celeste Woodard Brown | Nurse Practitioner | 751 Bayou Pines East Dr Ste L, Lake Charles, LA 70601-7196 | 2020-07-31 |
| 1306455498 | Headache Center Nola, LLC | Nurse Practitioner | 2221 Clearview Pkwy Ste 203, Metairie, LA 70001-2497 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
| City | ABITA SPRINGS |
| Zip Code | 70420 |
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| 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.