Individual
KRISTINE BRAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
134 CORPORATE DR, BEAVER DAM, WI 53916-3116
(920) 356-1000
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-2200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2985-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679633580
—
WI
Enumeration date
12/11/2006
Last updated
01/31/2022
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