Organization · Type 2 NPI
Breakaway Functional Medicine
Nurse Practitioner · Bismarck, ND
Practice location
319 S Mandan St
Bismarck, ND 58504-5558
Mailing address
1409 Bayview Ct
Bismarck, ND 58504-7087
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health & Wellness Coach | 171400000X | None listed |
| Nurse Practitioner Primary | 363L00000X | None listed |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
Other nurse practitioner providers in Bismarck
About NPI 1780528307
Breakaway Functional Medicine's National Provider Identifier is 1780528307, issued on Apr 15, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Bismarck, ND. The record was last updated on Apr 15, 2026.