Provider Demographics
NPI:1437510294
Name:BRAUN, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BRAUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2622 MENARDS DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-8075
Mailing Address - Country:US
Mailing Address - Phone:812-647-2210
Mailing Address - Fax:812-647-2165
Practice Address - Street 1:2622 MENARDS DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8075
Practice Address - Country:US
Practice Address - Phone:812-647-2210
Practice Address - Fax:812-647-2165
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021854A1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy