MEDICARE: MS. KRISTEN A. BRANCHE WHNP

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	363L00000X	Nurse Practitioner	RN254159L	PA
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	AP2657	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952376923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN A. BRANCHE WHNP

Provider Business Mailing Address
First Line	:	2155 E CONFERENCE DR STE 115
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-2604
Country	:	US
Telephone Number	:	480-831-2445
Fax Number	:	480-897-1283

Provider Business Practice Location Address
First Line	:	2155 E CONFERENCE DR STE 115
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-2604
Country	:	US
Telephone Number	:	480-831-2445
Fax Number	:	480-897-1283

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	03/07/2023

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