Individual
RITA BRAUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
370 S MAIN ST, CLINTONVILLE, WI 54929-1632
(715) 823-5161
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
135-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009845003
MEDICARE PTAN
WI
05
—
42905100
—
WI
Enumeration date
07/07/2006
Last updated
10/10/2013
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