Provider Demographics
NPI:1811988967
Name:STOYKE, BRIELLE J (CNM, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:BRIELLE
Middle Name:J
Last Name:STOYKE
Suffix:
Gender:F
Credentials:CNM, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 EXCHANGE ST W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1004
Mailing Address - Country:US
Mailing Address - Phone:651-232-1000
Mailing Address - Fax:
Practice Address - Street 1:11010 PRAIRIE LAKES DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3884
Practice Address - Country:US
Practice Address - Phone:952-800-7693
Practice Address - Fax:952-746-0887
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-131104-4367A00000X
MN8483363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
230L7STOtherBLUE CROSS BLUE SHIELD
COMPOtherCHAMPUS
0703753OtherMEDICA HEALTH PLANS
1023607OtherPREFERRED ONE
127841OtherU-CARE
941404500OtherMEDICAL ASSISTANCE
1079477OtherARAZ GROUP/AMERICAS PPO
2114054OtherFIRST HEALTH PLAN
HP30664OtherHEALTH PARTNERS