Provider Demographics
NPI:1134266232
Name:BRAUHN, NANCY ELLEN (PHD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ELLEN
Last Name:BRAUHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 LANDAU CT
Mailing Address - Street 2:
Mailing Address - City:ROBINS
Mailing Address - State:IA
Mailing Address - Zip Code:52328-9675
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5250 N PARK PL NE
Practice Address - Street 2:SUITE 209
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6221
Practice Address - Country:US
Practice Address - Phone:319-377-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00098106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist