Provider Demographics
NPI:1447423538
Name:BRAAFLAT, TAMMIE M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:M
Last Name:BRAAFLAT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:ND
Mailing Address - Zip Code:58784-0399
Mailing Address - Country:US
Mailing Address - Phone:701-628-2505
Mailing Address - Fax:701-628-3703
Practice Address - Street 1:615 6TH ST SE
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:ND
Practice Address - Zip Code:58784-4444
Practice Address - Country:US
Practice Address - Phone:701-628-2505
Practice Address - Fax:701-628-3703
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR30423363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily