Healthcare Provider Details

I. General information

NPI: 1245299833
Provider Name (Legal Business Name): KATRINA JOY BRUEMMER BALVANCE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 153RD ST W
ROSEMOUNT MN
55068-4946
US

IV. Provider business mailing address

3455 153RD ST W
ROSEMOUNT MN
55068-4946
US

V. Phone/Fax

Practice location:
  • Phone: 952-388-1904
  • Fax: 952-388-1948
Mailing address:
  • Phone: 952-388-1904
  • Fax: 952-388-1948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: