Individual
TERESA R BROST-JIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNNP
Contact information
Practice address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 520-5580
(763) 520-1411
Mailing address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 520-5580
(763) 520-1411
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R1485679
MN
363LN0005X
Critical Care Neonatal Nurse Practitioner
R1485679
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288668500
—
MN
Enumeration date
04/20/2006
Last updated
02/13/2013
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