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General NPI Number Information
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NPI Number | 1629442405
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Entity Type | Individual
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Provider Name | YISHEN WENDY BRADEN CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 2226 WISCONSIN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20007-4102
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Country | US
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Telephone | 120-294-4867
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Fax |
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Provider Business Mailing Address
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Address Line | 473 VALLEY AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-3719
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Country | US
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Telephone | 202-664-4018
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN1014307
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License Number State | DC
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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 | R187667
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License Number State | MD
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