| NPI | 1164098521 |
|---|---|
| Former Name | BREANNA MARIE FLICEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 8080) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 8080) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2021-10-15 |