Provider Demographics
NPI:1972172492
Name:BAADE, BROOK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BROOK
Middle Name:
Last Name:BAADE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:BROOK
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:227 ARDELEAN DR
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1215
Mailing Address - Country:US
Mailing Address - Phone:517-775-0505
Mailing Address - Fax:
Practice Address - Street 1:227 ARDELEAN DR
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1215
Practice Address - Country:US
Practice Address - Phone:517-775-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist