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Individual

MIRIAM BREHMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1207 N DOUGLASS ST, MALDEN, MO 63863-1351
(573) 276-3884
Mailing address
16225 SHADY LANE DR, DEXTER, MO 63841-8693
(573) 624-8423

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
117972
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
117972
LISCENSE
MO
Enumeration date
06/04/2007
Last updated
08/04/2010
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