Breanna Jacobs Pepin
Nurse Practitioner Nurse Practitioner - Neonatal
345 Smith Ave N
Saint Paul
, Minnesota 55102-2346
Breanna Jacobs Pepin
Nurse Practitioner Nurse Practitioner - Neonatal
345 Smith Ave N
Saint Paul
, Minnesota 55102-2346
(651) 220-6210
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About
Features
Specialties
- Nurse Practitioner
- Nurse Practitioner - Neonatal
Languages spoken
- English
Location
First Address
- Breanna Jacobs Pepin
- 345 Smith Ave N
- Saint Paul, MN
- Zip : 55102-2346
- Phone : (651) 220-6210
Second Address
- Breanna Jacobs Pepin
- 345 Smith Ave N
- Saint Paul, MN
- Zip : 55102-2346
- Phone : (651) 220-6210
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R1801237 | MN |
| N | 363LN0000X | Nurse Practitioner - Neonatal | R180123-7 | MN |
National Provider Identifier
| NPI | 1033419585 |
|---|---|
| Provider Name | Breanna Jacobs Pepin |
| First Address | Saint Paul, MN 55102-2346 |
| Second Address | Saint Paul, MN 55102-2346 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/11/2010 |
| Last Update Date | 28/06/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| ENROLLED | (05) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.