Provider Demographics
NPI:1609184100
Name:BRAUN, KRISTA D (CPTA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:D
Last Name:BRAUN
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 12TH ST.
Mailing Address - Street 2:PO BOX 422
Mailing Address - City:VICTORIA
Mailing Address - State:KS
Mailing Address - Zip Code:67671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 7TH ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:KS
Practice Address - Zip Code:67671
Practice Address - Country:US
Practice Address - Phone:785-735-2208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00903225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant