MEDICARE: CAROLANN MARIE BRAUN CD(DONA)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1144556671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLANN MARIE BRAUN CD(DONA)

Provider Business Mailing Address
First Line	:	10637 OTSEGO ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-4048
Country	:	US
Telephone Number	:	310-409-8982
Fax Number	:

Provider Business Practice Location Address
First Line	:	10637 OTSEGO ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-4048
Country	:	US
Telephone Number	:	310-409-8982
Fax Number	:	818-358-4495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2009
Last Update Date	:	11/21/2011

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