Individual provider Active NPI

Breanne Pink

  • Family Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1427694736
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A157447 Issued in IA
Practice address
1825 Logan Ave
Waterloo, IA 50703-1916
Phone
(319) 235-3607
Fax
(319) 235-3958
NPI assigned
Nov 21, 2019
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A157447 IA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G180392 IA

Addresses

Primary practice location

1825 Logan Ave
Waterloo, IA 50703-1916

Mailing address

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200221001552 IA Practitioner - Nurse Practitioner 2365879848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3913

212 W Dale St
Suite 100
Waterloo, IA 50703-1954
Phone (319) 235-3550

233 Vold Dr
Waterloo, IA 50703-1256
Phone 31923550900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Allen Memorial Hospital Corporation CurrentSince Jul 27, 2021 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Feb 17, 2020 Accepting new patients
Allen Memorial Hospital Corporation Psychiatry CurrentSince Jul 27, 2021 Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients
Cedar Valley Medical Specialists PC Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

855 A Ave NE
Ste 120
Cedar Rapids, IA 52402
Phone (319) 297-9350

164 W Dale St
Ste 6B
Waterloo, IA 50703

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

212 W Dale St
Ste 100
Waterloo, IA 50703
Phone (319) 235-3550

Interoperability endpoints

  • Direct secure messaging: bpink580874@direct.unitypoint.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1427694736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3607",
            "fax_number": "319-235-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3607",
            "fax_number": "319-235-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINK",
        "first_name": "BREANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A157447",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G180392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.