| 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 |