Provider Demographics
NPI:1366583593
Name:BRATSCH, ANNA JEAN (ATC)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:JEAN
Last Name:BRATSCH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:ANNA
Other - Middle Name:JEAN
Other - Last Name:ACKERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1011 43 1/2ST SW
Mailing Address - Street 2:204
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103
Mailing Address - Country:US
Mailing Address - Phone:320-295-2232
Mailing Address - Fax:
Practice Address - Street 1:901 8TH ST S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56562-0001
Practice Address - Country:US
Practice Address - Phone:218-299-4208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN19192255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer