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General NPI Number Information
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NPI Number | 1225861792
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Entity Type | Individual
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Provider Name | JORDYN BRAUER PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 1701 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-9907
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Country | US
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Telephone | 620-524-0799
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Fax |
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Provider Business Mailing Address
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Address Line | 622 SWEETWATER RD
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City | MAIZE
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State | KS
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Zip | 67101-8100
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Country | US
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Telephone | 925-667-6734
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | T-06198
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License Number State | KS
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