Brianne Joan Baloga, PHARMD
Individual provider Active NPI Pharmacist · Baxter, MN
NPI 1154067460 · NPPES record last updated May 10, 2022
Key facts
- NPI
- 1154067460
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 118851 (MN)
- Practice address
- 13060 Isle Dr
Baxter, MN 56425-8331 - Phone
- (218) 828-2880
- NPI assigned
- May 10, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118851 | MN | MD | Pharmacist |
| 14900-40 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14900-40 | WI | |
| Pharmacist | 183500000X | 118851 | MN | Yes |
Addresses
Primary practice location
13060 Isle Dr
Baxter, MN 56425-8331
Mailing address
12821 Executive Acres Rd
Brainerd, MN 56401-5262
Phone (651) 276-9017
Other providers in Baxter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.