Provider Demographics
NPI:1174347702
Name:LARKIN, BREONKA NICOLE (MSN APRN FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BREONKA
Middle Name:NICOLE
Last Name:LARKIN
Suffix:
Gender:F
Credentials:MSN APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5017 4TH PL
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-2020
Mailing Address - Country:US
Mailing Address - Phone:601-490-0461
Mailing Address - Fax:
Practice Address - Street 1:5017 4TH PL
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-2020
Practice Address - Country:US
Practice Address - Phone:601-490-0461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907064363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily