Individual provider · NPI-1

Brady Bahneman

Nurse Practitioner, Family · Duluth, MN

NPI number1760352272
StatusActive
Last updated in NPPESJan 6, 2026

Details

NPI
1760352272
Entity type
Individual (NPI-1)
Name
Brady Bahneman
Sex
Male
Sole proprietor
No
Enumeration date
Nov 10, 2025
Certification date
Jan 6, 2026
Last updated
Jan 6, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family13572MNYes

Practice location

4464 Ralston Dr
Duluth, MN 55811-1519

Phone 218-722-8634

Mailing address

4464 Ralston Dr
Duluth, MN 55811-1519

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