Individual
PHYLLIS A FOOTE MILBRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN MA LP
Contact information
Practice address
401 DIVISION STREET, SUITE C, NORTHFIELD, MN 55057
(507) 645-6249
(507) 645-0269
Mailing address
401 DIVISION STREET, SUITE C, NORTHFIELD, MN 55057
(507) 645-6249
(507) 645-0269
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3374
MN
163W00000X
Registered Nurse
R0691053
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48B03FO
BLUE CROSS BLUE SHIELD
MN
05
—
529167400
—
MN
Enumeration date
09/22/2006
Last updated
05/23/2008
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