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General NPI Number Information
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NPI Number | 1679253918
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Entity Type | Individual
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Provider Name | STEVEN JOHN BROKER APRN, CNP
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Gender | Male
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 502 E 2ND ST
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City | DULUTH
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State | MN
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Zip | 55805-1913
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Country | US
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Telephone | 218-786-8364
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 EAST 1ST STREET
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City | DULUTH
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State | MN
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Zip | 55805
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Country | US
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Telephone | 218-728-4491
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Fax | 218-728-4404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10495
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License Number State | MN
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