Provider Demographics
NPI:1265246623
Name:BRAUN, DUSTY SHANEE
Entity type:Individual
Prefix:
First Name:DUSTY
Middle Name:SHANEE
Last Name:BRAUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S LUCAS ST
Mailing Address - Street 2:
Mailing Address - City:LOWRY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64763-9114
Mailing Address - Country:US
Mailing Address - Phone:417-644-0032
Mailing Address - Fax:
Practice Address - Street 1:400 S LUCAS ST
Practice Address - Street 2:
Practice Address - City:LOWRY CITY
Practice Address - State:MO
Practice Address - Zip Code:64763-9114
Practice Address - Country:US
Practice Address - Phone:417-644-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide