Individual
ELIZABETH C BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5100 GAMBLE DR SUITE 100, MAIL STOP 31200A HELATHPARTNERS WEST CLINIC, SAINT LOUIS PARK, MN 55416-1582
(952) 541-2500
(952) 541-2539
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(952) 595-6455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23476
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52978000
—
MN
Enumeration date
03/02/2006
Last updated
02/08/2012
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