Healthcare Provider Details

I. General information

NPI: 1679063168
Provider Name (Legal Business Name): BRITTNEY MARIE BRAGER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 LABORE RD STE 7
VADNAIS HEIGHTS MN
55110-5113
US

IV. Provider business mailing address

711 KASOTA AVE SE
MINNEAPOLIS MN
55414-2842
US

V. Phone/Fax

Practice location:
  • Phone: 651-788-4444
  • Fax:
Mailing address:
  • Phone: 612-672-5128
  • Fax: 612-672-7320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number123355
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: