Individual provider · Type 1 NPI
Breanna Larae Damron, PA-C
Medical Physician Assistant · Portsmouth, OH
NPI number
1568077808
Active
Practice location
Envision Physician Services, 1805 27th St
Portsmouth, OH 45662
Mailing address
1404 S Calumet Dr
Worthington, KY 41183-9614
Other practice locations
- 1128 Ramey Ave, Worthington, KY 41183-9229 · (606) 547-5595
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | None listed |
| Medical Physician Assistant Primary | 363AM0700X | 50.007373RX (OH) |
| Physician Assistant | 363A00000X | TC031 (KY) |
| Medical Physician Assistant | 363AM0700X | TC031 (KY) |
| Surgical Physician Assistant | 363AS0400X | TC031 (KY) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Portsmouth
About NPI 1568077808
Breanna Larae Damron, PA-C's National Provider Identifier is 1568077808, issued on Sep 14, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Portsmouth, OH. The record was last updated on Oct 6, 2023.