Provider Demographics
NPI:1891864443
Name:BRAUSEN, KURT NORMAN (DC)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:NORMAN
Last Name:BRAUSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 CLEVELAND AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1241
Mailing Address - Country:US
Mailing Address - Phone:651-698-9123
Mailing Address - Fax:651-699-5526
Practice Address - Street 1:621 CLEVELAND AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1241
Practice Address - Country:US
Practice Address - Phone:651-698-9123
Practice Address - Fax:651-699-5526
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN198J1BROtherBLUE CROSS BLUE SHIELD
MN300450300Medicaid
U89674Medicare UPIN
MN198J1BROtherBLUE CROSS BLUE SHIELD