Basic Information
| Provider Information | |||||||||
| NPI: | 1750329645 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BREESE | ||||||||
| FirstName: | MAUREEN | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 220 | ||||||||
| Address2: | 6961 HIGHWAY 3 | ||||||||
| City: | HAYFORK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960410220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306285517 | ||||||||
| FaxNumber: | 5306285524 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 INDEPENDENCE CIR | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959730258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308999153 | ||||||||
| FaxNumber: | 5308990142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 11/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LC1500X | 17216 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Community Health |
No ID Information.