Most Relevant Information
Provider Data
| NPI Number: | 1609879659 |
| Provider Name: | GLENDA CAROL BREAKFELL PETROFF FNPC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | RN099641 |
Most Important Dates
| Enumeration Date: | 05/23/2005 |
| Last Updated: | 01/28/2008 |
Provider Practice Location
22070 HIGHWAY 59
ABITA SPRINGS
LA
70420
Practice Location Phone/Fax
| Phone: | 9858920879 |
| Fax: | 9858752384 |
Provider Mailing Location
1514 JEFFERSON HWY
NEW ORLEANS
LA
70121
Provider Mailing Phone/Fax
| Phone: | 5048424000 |
| Fax: |