Provider Demographics
NPI:1093496291
Name:BRAUN, BRANDI LYNN (NP)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNN
Last Name:BRAUN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 APPLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-3814
Mailing Address - Country:US
Mailing Address - Phone:320-815-7574
Mailing Address - Fax:
Practice Address - Street 1:4503 COLEMAN ST STE 208
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-2007
Practice Address - Country:US
Practice Address - Phone:701-354-0964
Practice Address - Fax:701-354-0966
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDF06232154363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily