Breanna Blue
In Home Supportive Care in Rochester, NY. Individual provider (NPI-1).
NPI number1144776782
StatusActive
Last updated in NPPESSep 1, 2016
Details
- NPI
- 1144776782
- Entity type
- Individual (NPI-1)
- Name
- Breanna Blue
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 1, 2016
- Last updated
- Sep 1, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Other names
- Breanna Mathis (Former Name)
Practice location
90 Kron StRochester, NY 14619-2036
Phone 585-397-2675
Mailing address
90 Kron StRochester, NY 14619-2036
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