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General NPI Number Information
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NPI Number | 1881998847
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Entity Type | Individual
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Provider Name | MARK BRAUN
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Gender | Male
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 4110 BRIARGATE PKWY STE 140
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7836
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Country | US
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Telephone | 719-364-8346
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Fax | 303-306-7753
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Provider Business Mailing Address
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Address Line | P.O. BOX 173891
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City | DENVER
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State | CO
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Zip | 80217-9294
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Country | US
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Telephone | 303-306-7783
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Fax | 303-306-7753
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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 | 164745
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 990074
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License Number State | CO
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