Brockberg, Andrea E

Brockberg, Andrea E is an individual health care provider with primary practice located at 2603 White Bear Ave N , Maplewood MN 55109-5110. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Brockberg, Andrea E can be contacted via phone (651) 600-3035.

Contact Information

Primary practice address
2603 White Bear Ave N Maplewood MN 55109-5110
Phone: (651) 600-3035
Fax: (651) 348-8783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X R1697315 Minnesota

Profile Details

NPI number 1821034281
LBN Legal business name Brockberg, Andrea E
Credentials Women's Health Nurse Practitioner (WHNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Aug 28th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821034281 NPPES
Minnesota MEDICAID 861404100

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