Basic Information
| Provider Information | |||||||||
| NPI: | 1396766317 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLUGSRUD-BRECKENRIDGE | ||||||||
| FirstName: | MARCIA | ||||||||
| MiddleName: | REED | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD,PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 HEUBNER ROAD | ||||||||
| Address2: | |||||||||
| City: | FORT RILEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852397581 | ||||||||
| FaxNumber: | 7852408358 | ||||||||
| Practice Location | |||||||||
| Address1: | IACH | ||||||||
| Address2: | 650 HEUBNER RD | ||||||||
| City: | FORT RILEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664425808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867553016 | ||||||||
| FaxNumber: | 3867583212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2006 | ||||||||
| LastUpdateDate: | 11/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | ME45457 | FL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P2900X | ME45457 | FL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Pain Medicine | 2084P0804X | ME45457 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.