Provider Demographics
NPI:1114369410
Name:BRATON, JEREMY R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:R
Last Name:BRATON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 NW TOPEKA BLVD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66608-1831
Mailing Address - Country:US
Mailing Address - Phone:785-232-2591
Mailing Address - Fax:785-232-2579
Practice Address - Street 1:2110 NW TOPEKA BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66608-1831
Practice Address - Country:US
Practice Address - Phone:785-232-2591
Practice Address - Fax:785-232-2579
Is Sole Proprietor?:No
Enumeration Date:2013-07-27
Last Update Date:2013-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist