Provider Demographics
NPI:1174598841
Name:BRAUN, CONSTANCE H (FNP)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:H
Last Name:BRAUN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15290 PENNOCK LN
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7163
Mailing Address - Country:US
Mailing Address - Phone:952-431-8500
Mailing Address - Fax:952-883-5395
Practice Address - Street 1:15290 PENNOCK LN
Practice Address - Street 2:MAIL STOP 32200A
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7163
Practice Address - Country:US
Practice Address - Phone:952-431-8500
Practice Address - Fax:952-431-6966
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100711363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN385026900Medicaid
500000900Medicare ID - Type Unspecified
S80749Medicare UPIN