Individual
STEPHAN BRAUTIGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
4 PRINCESS RD STE 206, LAWRENCEVILLE, NJ 08648-2322
(609) 482-3701
Mailing address
4 PRINCESS RD STE 206, LAWRENCEVILLE, NJ 08648-2322
(609) 482-3701
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP015817
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144400
DOH-MH
PA
01
—
8963
DMHAS-MH
NJ
Enumeration date
12/30/2015
Last updated
09/05/2024
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