Provider Demographics
NPI:1801593868
Name:SPRINGSTED, BRETT ROBERT (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:ROBERT
Last Name:SPRINGSTED
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 WHITEWATER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-4157
Mailing Address - Country:US
Mailing Address - Phone:952-999-6097
Mailing Address - Fax:
Practice Address - Street 1:12301 WHITEWATER DR STE 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-4157
Practice Address - Country:US
Practice Address - Phone:952-999-6097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9924363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health