MEDICARE: BLAKE TRANBY-LAUDAHL PHARMD

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	1835X0200X	Oncology Pharmacist	124276	MN

General Provider Information

NPI Number	:	1548125610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLAKE TRANBY-LAUDAHL PHARMD

Provider Business Mailing Address
First Line	:	3931 LOUISIANA AVE S
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55426-5000
Country	:	US
Telephone Number	:	952-993-6181
Fax Number	:

Provider Business Practice Location Address
First Line	:	3931 LOUISIANA AVE S
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55426-5000
Country	:	US
Telephone Number	:	952-993-6181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	12/19/2025

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