| Doctor Name: | BREANA MICHELLE MACKEY |
| NPI Number: | 1699147397 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 1-130178 |
| Business Practice Address: | 110 Clinic St New Market, AL - 357618507 |
| Business Phone Number: | 2563792101 |
| Business Fax Number: | 2563792102 |
| Mailing Address: | Po Box 18488, HUNTSVILLE |
| State: | AL |
| Postal Code: | 358048488 |
| Phone Number: | 2565348659 |
| Fax Number: | 2565330276 |
| NPI Enumeration Date: | 10/21/2015 |
| NPI Last Update Date: | 10/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 1-130178 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |