Breckan Nicholas Ebnet
Individual provider Active NPI Athletic Trainer · Saint Peter, MN
NPI 1942776877 · NPPES record last updated Oct 18, 2018
Key facts
- NPI
- 1942776877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 800 W College Ave
Saint Peter, MN 56082 - Phone
- (320) 905-0383
- NPI assigned
- Oct 18, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gustavus Adolphus College | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
800 W College Ave
Saint Peter, MN 56082
Mailing address
510 3Rd Street West
Lake Lillian, MN 56253
Phone (320) 905-0383
Other providers in Saint Peter, MN
- Zachary Blake Dirks
- Makenna Douglas
- Julie K Drier
- Ashley Dungan
- Matthew James Eberhardt
- Ecumen
- Ecumen
- Egale Healthcare, LLC
- Alexandra Eggert
- Alex Eichner
All providers in Saint Peter, MN · Athletic Trainer in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.