Individual
NATHAN R BRAKKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1971
(757) 668-7000
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1971
(757) 668-7000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A108775
CA
207L00000X
Anesthesiology Physician
MD-52566
IA
207LP3000X
Pediatric Anesthesiology Physician
Primary
A108775
CA
207LP3000X
Pediatric Anesthesiology Physician
MD-52566
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972716470
—
CA
Enumeration date
05/08/2007
Last updated
01/09/2026
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