Provider Demographics
NPI:1346665452
Name:PULKRABEK, BRIANNA LYNN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:LYNN
Last Name:PULKRABEK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:BRIANNA
Other - Middle Name:LYNN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:223 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3620
Mailing Address - Country:US
Mailing Address - Phone:218-825-0803
Mailing Address - Fax:218-829-1761
Practice Address - Street 1:223 S 8TH ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-3620
Practice Address - Country:US
Practice Address - Phone:218-825-0803
Practice Address - Fax:218-829-1761
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH5489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDRPH5489OtherPHARMACY LICENSE
MN121232OtherPHARMACY LICENSE