Individual
BRAXTON GILLIS MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 VALLEY DR STE A, WAYNE, NE 68787-2277
(402) 369-6449
Mailing address
1102 MAIN ST, WAYNE, NE 68787-1120
(402) 369-6449
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NE
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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