Individual
AMY JOY BRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4000 28TH AVE S, MOORHEAD, MN 56560-7926
(701) 234-3200
Mailing address
4000 28TH AVE S, MOORHEAD, MN 56560-7926
(701) 234-3200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R191121-1
MN
363L00000X
Nurse Practitioner
R33406
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R191121-1
REGISTERED NURSE LICENSE
MN
01
—
R33406
REGISTERED NURSE LICENSE
ND
Enumeration date
04/19/2015
Last updated
04/19/2015
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