| Doctor Name: | MARIE L BREKKEN |
| NPI Number: | 1023035029 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PAC0143 |
| Business Practice Address: | 1720 University Dr S Fargo, ND - 581034940 |
| Business Phone Number: | 7012804375 |
| Business Fax Number: | 7014615764 |
| Mailing Address: | 1720 University Dr S, FARGO |
| State: | ND |
| Postal Code: | 581034940 |
| Phone Number: | 7012804375 |
| Fax Number: | 7014615764 |
| NPI Enumeration Date: | 07/16/2006 |
| NPI Last Update Date: | 09/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PAC0143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |