NPI 1457451981 · live from the CMS NPI Registry
Ilene Brackin, PA-C
Physician Assistant, Surgical in Bismarck, ND. National Provider Identifier 1457451981, active.
NPI record
| NPI | 1457451981 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 310 N 10th St, Bismarck, ND 58501 |
| Practice phone | 701-530-7500 |
| Enumerated | September 24, 2006 |
| Last updated | December 28, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | PAC0236 (ND) |
| Physician Assistant, Surgical | 363AS0400X | PAC0236 (ND) |
| Physician Assistant, Surgical primary | 363AS0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.