Provider Demographics
NPI:1811494099
Name:AUBRECHT, SERINA (NMD)
Entity type:Individual
Prefix:DR
First Name:SERINA
Middle Name:
Last Name:AUBRECHT
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7908 BRYANT COURT NORTH
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-2071
Mailing Address - Country:US
Mailing Address - Phone:612-584-0016
Mailing Address - Fax:
Practice Address - Street 1:7908 BRYANT COURT NORTH
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55444-2071
Practice Address - Country:US
Practice Address - Phone:612-584-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN229133N00000X, 133NN1002X
CAND987175F00000X
AZ18-1718175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education