BREANNE MASSUNG BAUTISTA (NPI# 1932676269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932676269 |
| Entity Type | Individual |
| Full Name | BREANNE MASSUNG BAUTISTA |
| Credential | NNP-BC |
| Practice Address |
550 Medical Center Blvd Lawrenceville GA 30046 |
| Mailing Address |
550 Medical Center Blvd Lawrenceville GA 30046-7688 |
| Practice Telephone | 3783123970 |
| Mailing Telephone | 6783123970 |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
RN203901 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
550 MEDICAL CENTER BLVD |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184851008 | Ima S Thompson | Pediatrics | 550 Medical Center Blvd, Lawrenceville, GA 30046-7688 | 2009-06-18 |
| 1508403783 | Heather Leigh Farhy | Pediatrics | 550 Medical Center Blvd, Lawrenceville, GA 30046-7688 | 2019-12-05 |
| 1639728777 | Suzanne M Tillman | Pediatrics | 550 Medical Center Blvd, Lawrenceville, GA 30046-7688 | 2019-09-11 |
| 1467843417 | Dawn Cannova | Nurse Practitioner | 550 Medical Center Blvd, Lawrenceville, GA 30046-7688 | 2015-02-12 |
| 1952707028 | Angelan Bryan | Nurse Practitioner | 550 Medical Center Blvd, Lawrenceville, GA 30046-7688 | 2014-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982239596 | Riley Claire Cullen | Nurse Practitioner | 1000 Medical Center Blvd, Lawrenceville, GA 30046-7694 | 2020-03-04 |
| 1194117952 | Melissa Bell Murphy | Nurse Practitioner | 1000 Medical Center Blvd, Lawrenceville, GA 30046-7694 | 2015-03-03 |
| 1467843417 | Dawn Cannova | Nurse Practitioner | 550 Medical Center Blvd, Lawrenceville, GA 30046-7688 | 2015-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265944896 | Jennifer Michelle Kerhin | Nurse Practitioner | 777 Hemlock St Fl 3, Macon, GA 31201-2102 | 2017-11-05 |
| 1871034587 | Stephanie Joseph | Nurse Practitioner | 4316 Sublime Trl, Atlanta, GA 30349-8882 | 2017-03-14 |
| 1659810935 | Stephanie Gale Devers | Nurse Practitioner | 52 Johnny Wortham Rd, Newnan, GA 30263-4823 | 2017-02-19 |
| 1851757520 | Dawn Michelle Tripp | Nurse Practitioner | 10141 Flat Shoals Rd Sw, Covington, GA 30014-3707 | 2016-01-11 |
| 1295080414 | Christa Noel Brown | Nurse Practitioner | 142 Bryce Ryan Cir, Kingsland, GA 31548-7812 | 2012-07-14 |
| 1336398726 | Robin Domm Burch | Nurse Practitioner | 1790 Mulkey Rd Ste 10, Newborn Clinics of America LLC At Wellstar Cobb Clinic, Austell, GA 30106-1122 | 2008-09-10 |
| 1073730032 | Diane Arlene Doherty-chandler | Nurse Practitioner | 1191 Arbor Ln, Madison, GA 30650-3791 | 2007-04-19 |
| 1396886370 | Barbara Elaine Smith | Nurse Practitioner | 5335 Spot Creek Dr, Cumming, GA 30040-9554 | 2007-02-10 |
| 1245315118 | Sara Gelson Martin | Nurse Practitioner | 1762 Clifton Rd Ne Ste 103, Emory University, Atlanta, GA 30322-4001 | 2006-10-26 |
| 1861450058 | Paula Lynn Young | Nurse Practitioner | 2701 North Decatur Rd, Dekalb Medical Center, Decatur, GA 30033 | 2006-05-04 |
| Find all providers with the same taxonomy | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
Please comment or provide details below to improve the information on BREANNE MASSUNG BAUTISTA.
| 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.