Individual provider Active NPI

Breanna M Wenner

  • Gastroenterology Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1649104555
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology Registered NurseTaxonomy code 163WG0100X
License
1797901 Issued in MN
Practice address
3001 Broadway St NE Ste 120
Minneapolis, MN 55413-2196
Phone
(612) 871-1145
NPI assigned
Jun 9, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X 1797901 MN Primary

Addresses

Primary practice location

3001 Broadway St NE Ste 120
Minneapolis, MN 55413-2196

Mailing address

3001 Broadway St NE Ste 120
Minneapolis, MN 55413-2196
Phone (612) 871-1145

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1649104555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 BROADWAY ST NE STE 120",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132196",
            "telephone_number": "612-871-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BROADWAY ST NE STE 120",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132196",
            "telephone_number": "612-871-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNER",
        "first_name": "BREANNA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "MN",
            "license": "1797901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.