Provider Demographics
NPI:1982716130
Name:BRAUN, YVETTE DENISE (DC)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:DENISE
Last Name:BRAUN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6127
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85628
Mailing Address - Country:US
Mailing Address - Phone:520-281-1300
Mailing Address - Fax:520-281-4185
Practice Address - Street 1:1821 N MASTICK WAY #1
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621
Practice Address - Country:US
Practice Address - Phone:520-281-1300
Practice Address - Fax:520-281-4185
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U45891Medicare UPIN
DC5083Medicare ID - Type Unspecified