Jenna Breseman

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

1011 Meadowlands Dr Ste 1And2
White Bear Lake, MN 55127-2339

Phone

(612) 260-8432

NPI assigned

Jan 24, 2022

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 24, 2022.

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1194477869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 INDUSTRIAL DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559010700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MEADOWLANDS DR STE 1AND2",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551272339",
            "telephone_number": "612-260-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESEMAN",
        "first_name": "JENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joryn Bowen, MA, LPCC
• Kristin Bowers
• Andrew Philip Braum, MA LPCC
• Josalin Rose Brausen
• Craig L Bremseth, DDS
• Jessica Danielle Briggs
• Catherine Brosious
• Gerard Browne, L.AC.
• Alison Brunmeier
• Khadijah Desiree Brunner

• All providers in White Bear Lake, MN
• Other Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.