Madisyn Lou Brekke I

Individual provider Active NPI Case Manager/Care Coordinator · Devils Lake, ND

NPI 1376010066 · NPPES record last updated Oct 31, 2018

Key facts

NPI
1376010066
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
000 (ND)
Practice address
524 4TH Ave NE Unit 19
Devils Lake, ND 58301-2400
Phone
(701) 662-7057
Fax
(701) 662-3360
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000NDMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ramsey Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 000 ND Yes

Addresses

Primary practice location

524 4TH Ave NE Unit 19
Devils Lake, ND 58301-2400

Mailing address

524 4TH Ave NE Unit 19
Devils Lake, ND 58301-2400
Phone (701) 662-7057

Other providers in Devils Lake, ND

All providers in Devils Lake, ND · Case Manager/Care Coordinator in North Dakota

Sources for this page

Verify at the official NPI Registry.