Healthcare Provider Details

I. General information

NPI: 1346198264
Provider Name (Legal Business Name): JOHN PAUL BRAUN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 N 22ND ST APT 810
OMAHA NE
68102-4818
US

IV. Provider business mailing address

2616 BURT STREET OMAHA
OMAHA NE
68178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 651-788-0172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: