Breanna Lagore

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703116626 Issued in MI

Practice address

2565 Dardy Dr
Brooklyn, MI 49230-9319

Phone

(517) 745-9384

NPI assigned

Jul 28, 2016

Last updated

Jul 28, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1063965887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 DARDY DR",
            "city": "BROOKLYN",
            "state": "MI",
            "postal_code": "492309319",
            "telephone_number": "517-745-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 DARDY DR",
            "city": "BROOKLYN",
            "state": "MI",
            "postal_code": "492309319",
            "telephone_number": "517-745-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGORE",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703116626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gene E Kielhorn, DO
• Kimberly Lynn-Lewis King, LPC
• Hollie Anna Kolcz, LPC
• Kaitlyn Kono, PHARMD
• Madison Kwiecinski, LLMSW
• Jennifer Lapinski, PA-C
• LJ Gallagher Psy D and Associates PLLC
• Matthew L. Logan, D.D.S.
• Julie Lowry
• Brooke L Luckhardt

• Licensed Practical Nurse in Brooklyn, MI
• Providers in Brooklyn, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.