Healthcare Provider Details

I. General information

NPI: 1700186343
Provider Name (Legal Business Name): SANDRA LEE BRASWELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA LEE GILBERT APRN

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 FRANKLIN RD
MONTICELLO KY
42633-2245
US

IV. Provider business mailing address

PO BOX 969
SOMERSET KY
42502-0969
US

V. Phone/Fax

Practice location:
  • Phone: 606-396-3534
  • Fax: 606-396-3535
Mailing address:
  • Phone: 606-396-3534
  • Fax: 606-396-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3006692
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3006692
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: