Provider Demographics
NPI:1154328060
Name:BRATSCH, COLLEEN Q (DO FACOG)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:Q
Last Name:BRATSCH
Suffix:
Gender:F
Credentials:DO FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1272 GARRISON DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2598
Mailing Address - Country:US
Mailing Address - Phone:615-867-8030
Mailing Address - Fax:615-867-8195
Practice Address - Street 1:1272 GARRISON DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2598
Practice Address - Country:US
Practice Address - Phone:615-867-8030
Practice Address - Fax:615-848-1182
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO0000001574174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33080301OtherMEDICARE INDIVIDUAL PTAN
TN1510801Medicaid
TN33080301OtherMEDICARE INDIVIDUAL PTAN