Plackner, Brent D.

Plackner, Brent D. is an individual health care provider with primary practice located at 970 Pickett St N , Bayport MN 55003-1489. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Plackner, Brent D. can be contacted via phone (651) 779-5713.

Contact Information

Primary practice address
970 Pickett St N Bayport MN 55003-1489
Phone: (651) 779-5713
Fax: (651) 747-1621
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 865-23 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 11906 Minnesota

Profile Details

NPI number 1487647996
LBN Legal business name Plackner, Brent D.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Jan 19th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487647996 NPPES
Wisconsin Other 004156125 MEDICARE NUMBER
Wisconsin MEDICAID 42958400 MEDICARE NUMBER

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