Healthcare Provider Details

I. General information

NPI: 1518861418
Provider Name (Legal Business Name): BROOKE LOGE APRN, AGCNS, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BROOKE SCHROEDER

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEDICAL CENTER DR
FAIRMONT MN
56031-4575
US

IV. Provider business mailing address

14 ELM BLVD
BLUE EARTH MN
56013-3002
US

V. Phone/Fax

Practice location:
  • Phone: 800-234-6141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number687
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: