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NPI 1205923018

NPI 1205923018 : ROBERTA LEA BRAML RN : ALMENA, WI

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General NPI Number Information
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    NPI Number           |    1205923018
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERTA LEA BRAML RN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/05/2006
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    Last Update Date     |    07/09/2007
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Provider Practice Location Address
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    Address Line         |    1329 6TH ST 
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    City                 |    ALMENA
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    State                |    WI
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    Zip                  |    54805-9562
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    Country              |    US
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    Telephone            |    715-357-3478
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1329 6TH ST 
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    City                 |    ALMENA
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    State                |    WI
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    Zip                  |    54805-9562
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    Country              |    US
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    Telephone            |    715-357-3478
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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        |    163WH0200X
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    Taxonomy Name        |    Home Health Registered Nurse
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    License Number       |    94199
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    License Number State |    WI
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