Provider Demographics
NPI:1992032130
Name:BRAYKO, KRISTA ANN (ND)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:ANN
Last Name:BRAYKO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3817 STEPHENS AVE
Mailing Address - Street 2:STE. 2
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8505
Mailing Address - Country:US
Mailing Address - Phone:406-926-2290
Mailing Address - Fax:406-258-0540
Practice Address - Street 1:3817 STEPHENS AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8505
Practice Address - Country:US
Practice Address - Phone:406-926-2290
Practice Address - Fax:406-258-0540
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT124175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath