MEDICARE: CENTRAL MINNESOTA DERMATOLOGY, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1285220079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL MINNESOTA DERMATOLOGY, PA

Provider Business Mailing Address
First Line	:	1903 S 6TH ST STE 3
Second Line	:
City	:	BRAINERD
State	:	MN
Zip	:	56401-4599
Country	:	US
Telephone Number	:	218-454-3376
Fax Number	:	218-454-4263

Provider Business Practice Location Address
First Line	:	1903 S 6TH ST STE 3
Second Line	:
City	:	BRAINERD
State	:	MN
Zip	:	56401-4599
Country	:	US
Telephone Number	:	218-454-3376
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KRISTINA MARIE BRITTON
Credential	:	MD
Telephone Number	:	218-454-3376

Provider Enumeration Date	:	12/15/2020
Last Update Date	:	01/19/2026

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