Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Krystine Amber Breedlove, ACNPC-AG

Individual provider Acute Care Nurse Practitioner · NPI 1376146910

Krystine Amber Breedlove, ACNPC-AG is a Nurse Practitioner in Fond Du Lac, Wisconsin. Qualified in 2020, 6 years ago. Practices with Banner Hospital Based Physicians Arizona LLC, a 641-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arizona and Wisconsin.

Years since qualifying
6
Licensed in
AZ, WI
In the registry since
2020
Specialties on file
4
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Practice location Address checks out

210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone: (920) 907-7500
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (2)

  • 10401 W Thunderbird Blvd, Sun City, AZ 85351-3004 — (623) 832-4728
  • 14502 W Meeker Blvd, Sun City West, AZ 85375-5282 — (623) 524-8814

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 249005 (AZ)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 249005 (AZ)
Nurse Practitioner Taxonomy 363L00000X · Licence 17458-33 (WI)
Registered Nurse Taxonomy 163W00000X · Licence RN201982 (AZ)

Record details

NPI number1376146910
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNPC-AG
Sole proprietorNo
NPI enumeratedNovember 17, 2020
Last updated in NPPESFebruary 24, 2026
Certification dateFebruary 24, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Banner Hospital Based Physicians Arizona Llc — 641 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients28
Services billed 46 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Banner Hospital Based Physicians Arizona LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 641 clinicians in the practice; 12 are shown here.

Other providers in Fond Du Lac