Provider Demographics
NPI:1255543187
Name:BRAUTIGAM, CAROL (RN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BRAUTIGAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 S PARKER RD
Mailing Address - Street 2:NURSING EDUCATION, 3RD FL.
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1622
Mailing Address - Country:US
Mailing Address - Phone:303-636-2989
Mailing Address - Fax:303-636-2997
Practice Address - Street 1:2550 S PARKER RD
Practice Address - Street 2:NURSING EDUCATION, 3RD FL.
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1622
Practice Address - Country:US
Practice Address - Phone:303-636-2989
Practice Address - Fax:303-636-2997
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41661207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine