NPI 1720075666 · live from the CMS NPI Registry
Lisa R. Braun, PA-C
Physician Assistant, Medical in Wahpeton, ND. National Provider Identifier 1720075666, active.
NPI record
| NPI | 1720075666 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 332 2nd Ave N, Wahpeton, ND 58075 |
| Practice phone | 701-642-7000 |
| Mailing address | Po Box 21, 104 W 3rd Street, Rosholt, SD 57260 |
| Enumerated | October 5, 2005 |
| Last updated | April 2, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 0493 (SD) |
| Physician Assistant | 363A00000X | 9723 (MN) |
| Physician Assistant, Medical primary | 363AM0700X | PAC0387 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.