Robin Lynn Broen

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2462314 Issued in MN

Practice address

3012 129TH Ave NE
Blaine, MN 55449

NPI assigned

Feb 6, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Robin Lynn Freitag Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1043719016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11554 ZION STREET NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "612-730-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 129TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROEN",
        "first_name": "ROBIN",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2462314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "FREITAG",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Boyd, PA-C
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• Krista Renee Brenno, M.A., L.P.C., L.A.DC
• Ava Helen Brigham
• Kristin Broback, NP, C
• Melissa Brogger, MA LADC
• Brookdale Senior Living Communities Inc
• Andrew William Brown, D.C.
• Carolyn L Brown
• Deborah Ann Brown, APNP

• Registered Nurse in Blaine, MN
• Providers in Blaine, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.