LISA MARIE BREITERMAN CNP PMHNP-BC NPI 1053670968

NPI Information

  • NPI: 1053670968
  • Provider Name: LISA MARIE BREITERMAN, CNP, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 115 N 7TH ST STE 6
    SPEARFISH, SD
    ZIP 57783
  • Phone: (605) 645-0100

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NPI Details

Lisa Marie Breiterman, CNP, PMHNP-BC is a psychiatric/mental health nurse practitioner in Spearfish, SD with 13 years of experience. Lisa Marie Breiterman, CNP, PMHNP-BC NPI is 1053670968. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

115 N 7TH ST STE 6
SPEARFISH, SD
ZIP 57783-710
Phone: (605) 645-0100
Fax: (605) 717-1009

The NPI 1053670968 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/11/2012 and was last updated on 9/27/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse094553ARIZONANo
2363LF0000XNurse PractitionerFamilyAP4605ARIZONANo
3363LP0808XNurse PractitionerPsychiatric/Mental HealthAP11187ARIZONANo
4363LP2300XNurse PractitionerPrimary CareAP4605ARIZONANo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthCP003354SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1733126MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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