Provider Demographics
NPI:1417997545
Name:BRAMLETT, ELIZABETH ANN (CNM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:BRAMLETT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:WEHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM ARNP
Mailing Address - Street 1:5 TAMPA GENERAL CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3601
Mailing Address - Country:US
Mailing Address - Phone:813-258-3309
Mailing Address - Fax:813-251-4454
Practice Address - Street 1:5 TAMPA GENERAL CIR STE 2
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-258-3309
Practice Address - Fax:813-251-4454
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3388882367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305352100Medicaid
FL305352100Medicaid