Individual
STEPHANIE JEAN BRECKENRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
600 W 98TH ST, BLOOMINGTON, MN 55420-4773
(952) 881-2651
Mailing address
16923 FESTAL AVE, FARMINGTON, MN 55024-7825
(406) 249-7056
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2063919
MN
363LF0000X
Family Nurse Practitioner
Primary
10772
MN
363LF0000X
Family Nurse Practitioner
201806936NP-PP
OR
Other
Enumeration date
08/01/2018
Last updated
06/13/2024
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