Individual
GRANT TYLER BREKKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2700 SNELLING AVE N, STE 400, ROSEVILLE, MN 55113-1719
(651) 697-5863
(855) 826-4934
Mailing address
15525 EAGLE SHORE DR, APPLE VALLEY, MN 55124-7831
(612) 247-4626
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
104950
MN
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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