Brockmann, Kent Gregory
Brockmann, Kent Gregory is an sole proprietor health care provider with primary practice located at 8673 Eagle Point Blvd , Lake Elmo MN 55042. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is his primary health care specialty. Brockmann, Kent Gregory can be contacted via phone (651) 209-9383.Contact Information
Primary practice address
8673 Eagle Point Blvd
Lake Elmo MN 55042
Phone: (651) 209-9383
Fax: (651) 209-9384
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 44519 | Minnesota |
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | 44519 | Minnesota |
| Ambulatory Health Care Facilities / Adult Mental Health | 261QM0850X | 48376-20 | Wisconsin |
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X |
Profile Details
| NPI number | 1245281823 |
|---|---|
| LBN Legal business name | Brockmann, Kent Gregory |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 16th, 2006 |
| Last updated | Jun 25th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245281823 | NPPES |
| Minnesota | MEDICAID | 087897900 | |
| Minnesota | Other | 273L3BR | |
| Minnesota | Other | 15-45530 |
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