Individual
MICHAEL SCOTT BRAGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Mailing address
PO BOX 725, SAINT CLOUD, MN 56302-0725
(320) 258-3090
(320) 258-3095
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R156983-8
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922264910
—
MN
Enumeration date
07/30/2008
Last updated
03/17/2009
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