IndividualActive
Breeley Henzen, OD
NPI 1780253633 · Optometrist · Lucedale, MS
Provider details
- NPI number
- 1780253633
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1032 (MS)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
727 Winter St
Lucedale, MS 39452-5949
Phone: (601) 947-2913
Fax: (601) 766-0212
Approximate (ZIP-level) locationGet directions
Mailing address
1113 Central Ave E
Wiggins, MS 39577-9605
Additional practice locations (1)
- 1113 Central Ave EWiggins, MS 39577-9605Phone: (601) 928-3914Fax: (601) 928-2207
Registry dates
- Enumerated
- 2021-06-23
- Last updated
- 2025-03-13
- Certified
- 2025-03-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.