Breanne Nicole Stenseth, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

7379 Issued in MN

Practice address

7801 E Bush Lake Rd Ste 400
Minneapolis, MN 55439-3113

Phone

(612) 209-9622

NPI assigned

Dec 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Breanne Nicole Fackler Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• LTC Professionals, PLLC

  • Internal Medicine Physician
  • Bloomington, MN
  • NPI 1417251935
  Medicare reassignment NPD

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1508462813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 E BUSH LAKE RD",
            "address_2": "STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554393113",
            "telephone_number": "952-479-4261",
            "fax_number": "866-691-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 E BUSH LAKE RD STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554393113",
            "telephone_number": "612-209-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENSETH",
        "first_name": "BREANNE",
        "middle_name": "NICOLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "7379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNE",
            "last_name": "FACKLER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Lee Stender, PHARM.D.
• Katherine E Stender, NP
• Erik N Stene, MD
• Kyle Stengel, DPT
• Asha Stenquist
• Chris (None) Stenseth, NP
• Kathryn Patricia Stensgard, CPHT
• Courtney Stensland, M.S., CCC-SLP
• Olivia Erin Stensrud, DC
• Linda Stenstadvold, LICSW

• Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.