Provider Demographics
NPI:1669809711
Name:BRATSCHIE, ALEXANDRA (CNM, WHNP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:BRATSCHIE
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1830 BLAKE AVE STE 208
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4261
Practice Address - Country:US
Practice Address - Phone:970-945-2238
Practice Address - Fax:970-928-8926
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991393367A00000X
MI4704307971367A00000X, 363LF0000X
COAPN.0991393-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704307971OtherSTATE LICENSE