Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Breakaway Functional Medicine

Organization Health & Wellness Coach · NPI 1780528307

Breakaway Functional Medicine is a Health & Wellness Coach in Bismarck, North Dakota. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
2

Practice location Address checks out

319 S Mandan St
Bismarck, ND 58504-5558
Phone: (480) 262-0249
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X
Health & Wellness Coach Taxonomy 171400000X

Record details

NPI number1780528307
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Austin Mill — Owner · (480) 262-0249
NPI enumeratedApril 15, 2026
Last updated in NPPESApril 15, 2026
Certification dateApril 15, 2026
Mailing address1409 Bayview Ct, Bismarck, ND 58504-7087

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