Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KENT GREGORY BROCKMANN, MD
Active Sole ProprietorDR. KENT GREGORY BROCKMANN, MD is a Mental Health Clinic healthcare provider located in LAKE ELMO, Minnesota. NPI 1245281823 is currently active in the NPPES registry. Verify at CMS.
Mental Health Clinic · LAKE ELMO, MN
Registration Details
- NPI Number
- 1245281823
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 16, 2006 (20.248198027598 yrs)
- Last Updated
- Jun 25, 2013
- Licenses
-
44519 (MN)44519 (MN)48376-20 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8673 EAGLE POINT BLVDLAKE ELMO, MN, 55042Browse MN providers · Browse ZIP 55042
- Phone
- 6512099383
- Fax
- 6512099384
- Primary Specialty
-
Mental Health Clinic
261QM0801X
- Additional Specialty
- Mental Health Clinic
- Additional Specialty
- Adult Mental Health Clinic
- Additional Specialty
- Adolescent and Children Mental Health Clinic
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.