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General NPI Number Information
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NPI Number | 1174281000
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Entity Type | Individual
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Provider Name | STEPHANIE ANN BRADEN CNM
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Gender | Female
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 6855 SPRING VALLEY DR STE 125
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City | HOLLAND
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State | OH
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Zip | 43528-9374
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Country | US
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Telephone | 419-389-0492
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Fax | 419-381-0751
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Provider Business Mailing Address
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Address Line | 11748 BROOKSHIRE ST
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City | TEMPERANCE
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State | MI
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Zip | 48182-9611
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Country | US
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Telephone | 734-735-6081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | APRN.CNM.0019497
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License Number State | OH
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