Misty Breaux, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R045218 Issued in SD

Practice address

Hwy 160/163 Building Ka 2010
Kayenta, AZ 86033

Phone

(928) 697-4100

NPI assigned

Mar 27, 2015

Last updated

Mar 27, 2015By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1831583715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 ELK DRIVE",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "985-518-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 160/163 BUILDING KA 2010",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "86033",
            "telephone_number": "928-697-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "MISTY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R045218",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "SD",
            "license": "R045218",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060012",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha Dawn Bordeaux
• Amanda Jo Bradley
• Dan Bradley Jr., HT
• Donna Ellen Bradley, RN
• Allison Brandum, RN
• Craig S Bruce, DDS
• Steven Scott Burns
• Pauletta A Butterfly, SWLC
• Leah Blanche Calamity
• Richard Lee Campbell, RN

• Registered Nurse in Kayenta, AZ
• Providers in Kayenta, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.