Individual provider · Type 1 NPI

Brandon James Gustafson

Student in an Organized Health Care Education/Training Program · Mankato, MN

NPI number 1952069403 Active

Practice location

228 Wiecking Ctr
Mankato, MN 56001-6062

Call (507) 389-1866 Map

Mailing address

10220 Palm St NW
Coon Rapids, MN 55433-5139

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1952069403

Brandon James Gustafson's National Provider Identifier is 1952069403, issued on Dec 1, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Mankato, MN. The record was last updated on Dec 1, 2021.