Kimmy Renea Breckenridge, LPN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

70881 Issued in OK

Practice address

5304 SW Tyler Ave
Lawton, OK 73505-5750

Phone

(580) 351-8520

NPI assigned

Dec 16, 2019

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": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1366080830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 SW TYLER AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055750",
            "telephone_number": "580-351-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 SW TYLER AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055750",
            "telephone_number": "580-351-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "KIMMY",
        "middle_name": "RENEA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "OK",
            "license": "70881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon K Ross OD PC
• Patricia Brandon, PH.D.
• Tiffany Lynn Brantley
• Breastfeeding Guidance Center of Southwest Oklahoma
• Jacquelyn Breaux, CRNA
• Ashley Nicole Bredy, DC
• Jodi Breeden
• Brooke A Brehm, RBT
• Breland Health & Rehab Group Inc.
• Joseph Brent Brennan, PHARM.D.

• All providers in Lawton, OK
• Licensed Vocational Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.