| Doctor Name: | CONNIE JO BRAYBROOK |
| NPI Number: | 1053685925 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | 21142 |
| Business Practice Address: | Psc 482 Box 105 Fpo, AP - 963620199 |
| Business Phone Number: | 08044415338 |
| Business Fax Number: | |
| Mailing Address: | Psc 482 Box 105, FPO |
| State: | AP |
| Postal Code: | 963620199 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2012 |
| NPI Last Update Date: | 02/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 21142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |