Provider Demographics
NPI:1205523479
Name:BRAUN, MAE (RN)
Entity type:Individual
Prefix:
First Name:MAE
Middle Name:
Last Name:BRAUN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N ABSAROKA ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-1828
Mailing Address - Country:US
Mailing Address - Phone:307-248-2766
Mailing Address - Fax:
Practice Address - Street 1:635 N ABSAROKA ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-1828
Practice Address - Country:US
Practice Address - Phone:307-248-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health