Provider Demographics
NPI:1629442405
Name:BRADEN, YISHEN WENDY (CRNP)
Entity Type:Individual
Prefix:
First Name:YISHEN
Middle Name:WENDY
Last Name:BRADEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 VALLEY AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3719
Mailing Address - Country:US
Mailing Address - Phone:202-664-4018
Mailing Address - Fax:
Practice Address - Street 1:2226 WISCONSIN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-4102
Practice Address - Country:US
Practice Address - Phone:120-294-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1014307363LF0000X
MDR187667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily