Provider Demographics
NPI:1811659683
Name:BRANTNER, LAYNA MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAYNA
Middle Name:MARIE
Last Name:BRANTNER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:LAYNA
Other - Middle Name:MARIE
Other - Last Name:KRAMME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:848 S COBBLE CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-7872
Mailing Address - Country:US
Mailing Address - Phone:417-536-5771
Mailing Address - Fax:
Practice Address - Street 1:500 W MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2788
Practice Address - Country:US
Practice Address - Phone:417-243-7777
Practice Address - Fax:417-243-7778
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005008119363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2021034799OtherANCC