Provider Demographics
NPI:1396231247
Name:BRADEN, NATHAN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:BRADEN
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2652 KULL RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-7707
Mailing Address - Country:US
Mailing Address - Phone:740-687-0835
Mailing Address - Fax:740-687-9391
Practice Address - Street 1:7140 PORT SYLVANIA DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1176
Practice Address - Country:US
Practice Address - Phone:419-475-4449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023056363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health