Healthcare Provider Details

I. General information

NPI: 1275469702
Provider Name (Legal Business Name): CASSANDRA K GUTZMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 N 3RD ST
BRAINERD MN
56401-3054
US

IV. Provider business mailing address

523 N 3RD ST
BRAINERD MN
56401-3054
US

V. Phone/Fax

Practice location:
  • Phone: 218-828-7364
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number123743
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: