Provider Demographics
NPI:1851896245
Name:BRAUNDMEIER, JESSICA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:BRAUNDMEIER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 BOBCAT VILLAGE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34288-8974
Mailing Address - Country:US
Mailing Address - Phone:618-825-1456
Mailing Address - Fax:888-498-4926
Practice Address - Street 1:3149 BOBCAT VILLAGE CENTER RD
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34288-8974
Practice Address - Country:US
Practice Address - Phone:941-266-5629
Practice Address - Fax:888-498-4926
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.451726163W00000X
FLAPRN11029460363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11029460OtherSTATE LICENSE