Provider Demographics
NPI:1124000542
Name:BRAUN, LISA A (ARNP, JD)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:BRAUN
Suffix:
Gender:F
Credentials:ARNP, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 POCAHONTAS ST
Mailing Address - Street 2:REGIONAL SUPPORT ORGANIZATION
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23511-2133
Mailing Address - Country:US
Mailing Address - Phone:757-445-9040
Mailing Address - Fax:
Practice Address - Street 1:1084 POCAHONTAS ST
Practice Address - Street 2:REGIONAL SUPPORT ORGANIZATION
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511-2133
Practice Address - Country:US
Practice Address - Phone:757-445-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-20
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2564812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily