Individual
JENNIFER DAWN BRAKEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM
Contact information
Practice address
1076 W HAYDEN AVE, HAYDEN, ID 83835
(208) 772-2823
(208) 209-3120
Mailing address
PO BOX 265, HAYDEN, ID 83835-0265
(208) 699-5261
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MID-57
ID
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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