Individual
SHANNON RENEE BRAUTIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
24276 166TH STREET AIRPORT RD., EAGLE BUTTE, SD 57625
(605) 964-7724
Mailing address
24276 166TH STREET, AIRPORT RD, EAGLE BUTTE, SD 57625
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0063484
OK
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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