Provider Demographics
NPI:1174640437
Name:BRAATEN, ANN CECELIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CECELIA
Last Name:BRAATEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:N1797 MAPLE TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8730
Mailing Address - Country:US
Mailing Address - Phone:920-235-4910
Mailing Address - Fax:920-237-2046
Practice Address - Street 1:N1797 MAPLE TERRACE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-8730
Practice Address - Country:US
Practice Address - Phone:920-235-4910
Practice Address - Fax:920-237-2046
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12289-0401835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric