Individual
DR. STACIE BRASWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1313 W CHICAGO AVE, EAST CHICAGO, IN 46312-3316
(219) 398-9685
(219) 398-9695
Mailing address
951 TRANSPORT DR, VALPARAISO, IN 46383-8434
(219) 477-6082
(219) 465-9502
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01073089A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201194330
—
IN
Enumeration date
12/03/2009
Last updated
02/05/2015
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