Healthcare Provider Details

I. General information

NPI: 1265747471
Provider Name (Legal Business Name): KATRINA ANDREA BRAMSTEDT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 SOUTH MAIN STREET SUTIE 3000
SHERIDAN WY
82801
US

IV. Provider business mailing address

203 SOUTH MAIN STREET SUTIE 3000
SHERIDAN WY
82801
US

V. Phone/Fax

Practice location:
  • Phone: 415-754-9892
  • Fax:
Mailing address:
  • Phone: 415-754-9892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174V00000X
TaxonomyClinical Ethicist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: