BREON MAREE HENDERSON (NPI# 1851837454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851837454 |
| Entity Type | Individual |
| Full Name | BREON MAREE HENDERSON |
| Credential | RNC, MSN, CLC |
| Practice Address |
510 Cypress St Ste D Fort Bragg CA 95437-5411 |
| Practice Telephone | 7079645696 |
| Practice Fax Number | 7079646274 |
| Mailing Telephone | 7079645696 |
| Mailing Fax Number | 7079646274 |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
95023758 | CA | Nursing Service Providers |
| Street Address |
510 CYPRESS ST STE D |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881688380 | Lynette Kline | Optometrist | 510 Cypress St, Ste A, Fort Bragg, CA 95437-5411 | 2005-09-12 |
| 1982917571 | Jason David Moore | Acupuncturist | 510 Cypress St, Suite C, Fort Bragg, CA 95437-5411 | 2010-07-23 |
| 1912157264 | Andrea Lynn Shafir | Acupuncturist | 510 Cypress St, Suite C200, Fort Bragg, CA 95437-5411 | 2008-09-23 |
| 1962551119 | Kenneth Roger Susman | Specialist | 510 Cypress St, Suite B, Fort Bragg, CA 95437-5411 | 2007-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 163WL0100X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Lactation Consultant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689022154 | Helen Laquay | Registered Nurse | 2801 Compass Ct, Apt 207, Fort Bragg, NC 28307-2147 | 2016-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071098 | Corinne Breshears | Registered Nurse | 2848 Cantegra Gln, Escondido, CA 92025-7347 | 2020-10-16 |
| 1518571660 | Cherie Amour Mouton | Registered Nurse | 43854 46th St W, Lancaster, CA 93536-2365 | 2020-09-06 |
| 1629688007 | Christine Marie Decker-hughes | Registered Nurse | 11026 Corte Playa Tampico, San Diego, CA 92124-4101 | 2020-07-31 |
| 1659980662 | Jennifer Gathman | Registered Nurse | 16935 W Bernardo Dr Ste 105, San Diego, CA 92127-1657 | 2020-07-26 |
| 1497370654 | Tamera Rennaker | Registered Nurse | 4351 Fairwood Ct, Concord, CA 94521-1346 | 2020-06-13 |
| 1326667353 | Megan Atol | Registered Nurse | 24040 Martingale Way, Tehachapi, CA 93561-8352 | 2020-04-09 |
| 1194352724 | Jennifer W Rousseau | Registered Nurse | 134 Hahn Way, Cotati, CA 94931-5313 | 2020-03-24 |
| 1801428503 | Sara Whitehouse | Registered Nurse | 153 Ramona Way, Oceanside, CA 92057-7377 | 2020-02-10 |
| 1184267601 | Gina Sterchi | Registered Nurse | 327 1/2 Montrose Dr Apt A, Folsom, CA 95630-3381 | 2019-10-28 |
| 1013550219 | Kimberley Chilcote | Registered Nurse | 3901 Lone Tree Way Fl 2, Antioch, CA 94509-6200 | 2019-10-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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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.