Individual
REBECCA BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
15245 BLUEBIRD ST NW, MAIL STOP 39300A, ANDOVER, MN 55304-3538
(763) 587-4600
(763) 587-4615
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(763) 587-4600
(763) 587-4615
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9523
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
752533800
—
MN
Enumeration date
02/17/2006
Last updated
04/18/2016
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