Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Breanna Blackledge

Individual provider Nurse Practitioner · NPI 1770434524

Breanna Blackledge is a Nurse Practitioner in Palm Coast, Florida. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2026

Practice location Address checks out

61 Memorial Medical Pkwy Ste 2811
Palm Coast, FL 32164-5999
Phone: (386) 586-1955
Fax: (386) 586-1959
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN11044029 (FL)

Record details

NPI number1770434524
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 6, 2026
Last updated in NPPESJuly 2, 2026
Certification dateJuly 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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