Healthcare Provider Details

I. General information

NPI: 1245846740
Provider Name (Legal Business Name): ELIZABETH A BRAUN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 INTERNATIONAL DR
BLOOMINGTON MN
55425-1510
US

IV. Provider business mailing address

7900 INTERNATIONAL DR
BLOOMINGTON MN
55425-1510
US

V. Phone/Fax

Practice location:
  • Phone: 612-420-5293
  • Fax: 800-580-1281
Mailing address:
  • Phone: 612-420-5293
  • Fax: 800-580-1281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7749
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: