Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 13136 | ND |
NPI | 1013233436 |
---|---|
Provider Name | Dr. Amanda Susan Braaten |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Bismarck, ND 58501-4436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2010 |
Last Update Date | 08/01/2021 |