Individual
IVY MAY DEBRUYCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 255-5746
Mailing address
32604 UPLAND RD, TAYLORS FALLS, MN 55084-1828
(254) 709-2845
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
10072
MN
363LN0005X
Critical Care Neonatal Nurse Practitioner
2479164
MN
Other
Enumeration date
03/30/2023
Last updated
07/02/2024
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