Provider Demographics
NPI:1972792968
Name:BRAUCH, ALLISON NOEL (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:NOEL
Last Name:BRAUCH
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 S BEMISTON AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1988
Mailing Address - Country:US
Mailing Address - Phone:314-556-0055
Mailing Address - Fax:
Practice Address - Street 1:1400 LEMAY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-2408
Practice Address - Country:US
Practice Address - Phone:314-773-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017028435363LP0808X
MO2003005268163W00000X
MO2010037934363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health