| Doctor Name: | MISTY BREAUX |
| NPI Number: | 1831583715 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R045218 |
| Business Practice Address: | Hwy 160/163 Building Ka 2010 Kayenta, AZ - 86033 |
| Business Phone Number: | 9286974100 |
| Business Fax Number: | |
| Mailing Address: | 139 Elk Drive, EAGLE BUTTE |
| State: | SD |
| Postal Code: | 57625 |
| Phone Number: | 9855189432 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2015 |
| NPI Last Update Date: | 03/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WE0003X |
| License Number: | R045218 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SD |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |