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Individual

BREANNA JACOBS PEPIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(651) 220-6210
Mailing address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(651) 220-6210

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R1801237
MN
363LN0000X
Neonatal Nurse Practitioner
R180123-7
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
MN
Enumeration date
11/01/2010
Last updated
06/28/2017
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