Individual
AUTUMN BRANCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2601 BROADWAY N, FARGO, ND 58102-6704
(701) 234-2900
(701) 234-2996
Mailing address
2601 BROADWAY N, FARGO, ND 58102-6704
(701) 234-2900
(701) 234-2996
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0414
ND
Other
Enumeration date
07/16/2009
Last updated
05/17/2012
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