Breanna Laice Barry, FNP-C
Nurse Practitioner, Family in College Station, TX. Individual provider (NPI-1).
NPI number1649892753
StatusActive
Last updated in NPPESNov 7, 2023
Details
- NPI
- 1649892753
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Breanna Laice Barry
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 12, 2020
- Certification date
- Nov 7, 2023
- Last updated
- Nov 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F10190950 | TX | Yes |
Practice location
311 Houston Street Bldg 520College Station, TX 77843-7855
Phone 979-458-8337 · Fax 979-458-8326
Mailing address
1264 Tamu Bldg 520College Station, TX 77843-0001
Phone 979-458-8337 · Fax 979-458-8326
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