Provider Demographics
NPI:1760588859
Name:BREUTZMAN, GAYLE L (PA)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:L
Last Name:BREUTZMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 VETERANS DR
Mailing Address - Street 2:DEPT OF SURGERY
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-725-2000
Mailing Address - Fax:612-725-1920
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-725-2000
Practice Address - Fax:612-725-1920
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN9084363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical