Organization
BREAKAWAY FUNCTIONAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN MILL NP (OWNER)
(480) 262-0249
Entity
Organization
Contact information
Practice address
319 S MANDAN ST, BISMARCK, ND 58504-5558
(480) 262-0249
Mailing address
1409 BAYVIEW CT, BISMARCK, ND 58504-7087
(480) 262-0249
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/15/2026
Last updated
04/15/2026
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