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BRETT P NIENABER MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1710961776

Individual Registrant:
 BRETT P NIENABER MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
4317 W WOODMAN ST  PEQUOT LAKES, MN 56472-3473 US
Tel: 218-568-4416  Fax: --

Contact information for business:
523 N 3RD ST  BRAINERD, MN 56401-3054 US
Tel: 218-829-2861  Fax: --

Registration Information:
NPI: 1710961776
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
MN27359

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
148362500MN05




HEALTH CARE JOBS MN - Page 1



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