Individual
LISA R. BRAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
332 2ND AVE N, WAHPETON, ND 58075-4528
(701) 642-7000
Mailing address
PO BOX 21, 104 W 3RD STREET, ROSHOLT, SD 57260-0021
(605) 537-4350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0493
SD
363A00000X
Physician Assistant
9723
MN
363AM0700X
Medical Physician Assistant
Primary
PAC0387
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6824570
—
SD
Enumeration date
10/05/2005
Last updated
04/02/2008
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