Individual
EVELYN WILLIAMS BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
Mailing address
PO BOX 716, STEVENS POINT, WI 54481-0716
(573) 528-3892
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2017014611
MO
363LF0000X
Family Nurse Practitioner
Primary
CP001559
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2017014611
—
MO
Enumeration date
08/07/2017
Last updated
10/31/2019
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