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General NPI Number Information
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NPI Number | 1205096047
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Entity Type | Individual
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Provider Name | JAMI L BRAXTON MSN-FNP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 731 E SOUTHLAKE BLVD SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6377
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Country | US
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Telephone | 817-424-3366
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Fax | 817-424-3426
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Provider Business Mailing Address
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Address Line | 731 E SOUTHLAKE BLVD SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6377
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Country | US
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Telephone | 817-424-3366
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Fax | 817-424-3426
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 687942
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 687942
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License Number State | TX
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