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General NPI Number Information
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NPI Number | 1629400031
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Entity Type | Individual
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Provider Name | JENNIFER DAWN BRAUDWAY CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/07/2013
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 1504 TAUB LOOP
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City | HOUSTON
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State | TX
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Zip | 77030-1608
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Country | US
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Telephone | 713-873-2860
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Fax |
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Provider Business Mailing Address
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Address Line | 7331 EMERALD GLADE LN
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City | HUMBLE
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State | TX
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Zip | 77396-2946
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Country | US
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Telephone | 281-902-7468
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 777740
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 92675
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP124476
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License Number State | TX
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