| NPI | 1699075044 |
|---|---|
| Former Name | JACKIE BRAUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MI 4704259474) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN586505) |
| 363LA2100X Nurse Practitioner Acute Care (Licence: IL 209.010429) | |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2022-07-29 |