Healthcare Provider Details
I. General information
NPI: 1922445030
Provider Name (Legal Business Name): ERIC BRAMAN RN, QMRP, QMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/30/2013
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 E WARWICK DR
ALMA MI
48801-1010
US
IV. Provider business mailing address
301 S CRAPO ST SUITE 200
MT PLEASANT MI
48858-2941
US
V. Phone/Fax
- Phone: 989-463-2779
- Fax: 989-463-2064
- Phone: 989-772-5930
- Fax: 989-775-7701
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 4704288249 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: