Provider Demographics
NPI:1659307148
Name:BRADEN ANESTHESIA SERVICES PC
Entity Type:Organization
Organization Name:BRADEN ANESTHESIA SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:BRADEN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:830-660-7432
Mailing Address - Street 1:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59103-1155
Mailing Address - Country:US
Mailing Address - Phone:877-670-2447
Mailing Address - Fax:406-248-3346
Practice Address - Street 1:940 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0742
Practice Address - Country:US
Practice Address - Phone:877-670-2447
Practice Address - Fax:406-248-3346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00C93ROtherBLUE CROSS BLUE SHIELD
TX164111001Medicaid
MTM011000225Medicare PIN
TX164111001Medicaid