Individual
LISA A BRASCHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-058973
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051525875
—
AL
05
—
051556629
—
AL
01
—
51074344
BLUE SHIELD
AL
01
—
51525875
BLUE SHIELD
AL
01
—
51530494
BLUE SHIELD
AL
01
—
P00200457
PALMETTO GBA - RR MEDICAR
—
Enumeration date
05/11/2006
Last updated
07/08/2007
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