Basic Information
| Provider Information | |||||||||
| NPI: | 1508832254 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRETT | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 441 | ||||||||
| Address2: | |||||||||
| City: | LITCHFIELD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3206933233 | ||||||||
| FaxNumber: | 3206933290 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 SOUTH SIBLEY AVE | ||||||||
| Address2: | |||||||||
| City: | LITCHFIELD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3206933233 | ||||||||
| FaxNumber: | 3206933290 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 43608 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.