Individual
KATHERINE MARIE BREEZLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 W 66TH ST, EDINA, MN 55435-2111
(952) 914-1781
Mailing address
16581 HAVELOCK WAY, LAKEVILLE, MN 55044-6255
(952) 220-8978
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R-203335-0
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
CNP 3969
MN
Other
Enumeration date
07/06/2015
Last updated
07/07/2015
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