Provider Demographics
NPI:1669557450
Name:BRAUN, STACI ANNE (MD)
Entity type:Individual
Prefix:
First Name:STACI
Middle Name:ANNE
Last Name:BRAUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 COUNTRY SIDE ACRES DR
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-7360
Mailing Address - Country:US
Mailing Address - Phone:336-877-3229
Mailing Address - Fax:
Practice Address - Street 1:200 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640
Practice Address - Country:US
Practice Address - Phone:336-846-0789
Practice Address - Fax:336-846-0770
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC125740207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903129Medicaid
NC140YUOtherBLUE CROSS
NC140YUOtherBLUE CROSS
2039648Medicare ID - Type Unspecified