Breckenridge Wellness Clinic
Nurse Practitioner, Family in Flagstaff, AZ. Organization (NPI-2).
NPI number1659200699
StatusActive
Last updated in NPPESAug 11, 2026
Details
- NPI
- 1659200699
- Entity type
- Organization (NPI-2)
- Legal business name
- Breckenridge Wellness Clinic
- Organization subpart
- No
- Enumeration date
- May 15, 2026
- Certification date
- Aug 11, 2026
- Last updated
- Aug 11, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
2615 N 4th St Ste 6Flagstaff, AZ 86004-1812
Phone 928-549-0730
Mailing address
2615 N 4th St Ste 6Flagstaff, AZ 86004-1812
Phone 928-549-0730
Authorized official
Heather Breckenridge
Medical Director
9285890730
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