Provider Demographics
NPI:1780420927
Name:BARBERBRAUN, ALEXANDRIA AVA (FNP)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:AVA
Last Name:BARBERBRAUN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 W KING ST STE 201
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2117
Mailing Address - Country:US
Mailing Address - Phone:989-723-3168
Mailing Address - Fax:989-725-2962
Practice Address - Street 1:818 W KING ST STE 201
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2117
Practice Address - Country:US
Practice Address - Phone:989-723-3168
Practice Address - Fax:989-725-2962
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704367859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily