Individual
COURTNEY LYNN BREVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 656-7020
(320) 255-5714
Mailing address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 656-7020
(320) 255-5714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11586
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093120131
—
MN
Enumeration date
06/27/2014
Last updated
07/11/2024
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