Provider Demographics
NPI:1093245912
Name:BRANICK, KAITLIN ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:ANN
Last Name:BRANICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 S CLIFF AVE STE 601
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1032
Mailing Address - Country:US
Mailing Address - Phone:605-322-6930
Mailing Address - Fax:605-322-6931
Practice Address - Street 1:1301 S CLIFF AVE STE 601
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1032
Practice Address - Country:US
Practice Address - Phone:605-322-6930
Practice Address - Fax:605-322-6931
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD14323207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty