Provider Demographics
NPI:1548937675
Name:BRAUN, ALEXANDRIA RACHELLE LYNA (APRN)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:RACHELLE LYNA
Last Name:BRAUN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W 36TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1632
Mailing Address - Country:US
Mailing Address - Phone:785-533-1291
Mailing Address - Fax:
Practice Address - Street 1:115 W 36TH ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1632
Practice Address - Country:US
Practice Address - Phone:785-533-1291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS82228363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004942410001Medicaid
KS144230Medicaid