Doctor Name: | JOANNE L BRAUN |
NPI Number: | 1053500868 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | NP-181A |
Business Practice Address: | 623 South Main Street M/med/qi, Sa-1 Moscow, ID - 83843 |
Business Phone Number: | 2088822011 |
Business Fax Number: | 2088831853 |
Mailing Address: | 623 South Main Street, M/med/qi, Sa-1 MOSCOW |
State: | ID |
Postal Code: | 83843 |
Phone Number: | 2088822011 |
Fax Number: | 2088831853 |
NPI Enumeration Date: | 10/17/2007 |
NPI Last Update Date: | 07/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | NP-181A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |