GRANT TYLER BREKKEN (NPI# 1881084408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881084408 |
| Entity Type | Individual |
| Full Name | GRANT TYLER BREKKEN |
| Credential | CRNA |
| Practice Address |
2700 Snelling Ave N Ste 400 Roseville MN 55113-1719 |
| Mailing Address |
15525 Eagle Shore Dr Apple Valley MN 55124-7831 |
| Practice Telephone | 6516975863 |
| Practice Fax Number | 8558264934 |
| Mailing Telephone | 6122474626 |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 104950 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2700 SNELLING AVE N STE 400 |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-1719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881930204 | Cassidy Jones | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Ste 400, Roseville, MN 55113 | 2012-12-13 |
| 1164811154 | Stephanie Maryann Donnelly | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Roseville, MN 55113-1719 | 2015-01-14 |
| 1366870289 | Emily Kary | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Ste 400, Roseville, MN 55113-1719 | 2013-10-31 |
| 1689000473 | Crystal Ellison | Registered Nurse | 2700 Snelling Ave N, Suite 400, Roseville, MN 55113-1719 | 2013-09-24 |
| 1720414832 | Jacqueline Kay Ford Dufour | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Suite 400, Roseville, MN 55113-1719 | 2013-09-20 |
| 1366878423 | Sarah Mary Paulseth | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Suite 400, Roseville, MN 55113-1719 | 2013-09-20 |
| 1740616366 | Joel Walgenbach | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Suite 400, Roseville, MN 55113-1719 | 2013-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881238178 | Ange Barly Tapchom | Nurse Anesthetist, Certified Registered | 3217 Ardley Dr, Roseville, CA 95747-9017 | 2019-10-30 |
| 1245695535 | Molly Herseth | Nurse Anesthetist, Certified Registered | 1393 Colonial Dr, Roseville, MN 55113-4242 | 2015-12-31 |
| 1366878399 | Holly June Haehnel | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N Ste 400, Roseville, MN 55113-1783 | 2013-09-23 |
| 1881930204 | Cassidy Jones | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Ste 400, Roseville, MN 55113 | 2012-12-13 |
| 1477039535 | Amanda Wittmann | Nurse Anesthetist, Certified Registered | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2018-07-12 |
| 1982094116 | Allyson Kraska | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N Ste 400, Roseville, MN 55113-1783 | 2015-01-26 |
| 1164811154 | Stephanie Maryann Donnelly | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Roseville, MN 55113-1719 | 2015-01-14 |
| 1366870289 | Emily Kary | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Ste 400, Roseville, MN 55113-1719 | 2013-10-31 |
| 1154758126 | Justine Marie Lindgren | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N Ste 400, Roseville, MN 55113-1783 | 2013-10-04 |
| 1720414832 | Jacqueline Kay Ford Dufour | Nurse Anesthetist, Certified Registered | 2700 Snelling Ave N, Suite 400, Roseville, MN 55113-1719 | 2013-09-20 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.