Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 3 | CO |
NPI | 1053538033 |
---|---|
Provider Name | Jennifer Elizabeth Braun |
First Address | Longmont, CO 80503-6416 |
Second Address | Boulder, CO 80302-6329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |