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NPI Code Detail

MEDICARE: BRITTA BRADEN PA

MEDICARE:   BRITTA  BRADEN  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant1540WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083650709
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTA BRADEN PA
Provider Business Mailing Address
First Line : 3003 W GOOD HOPE RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53209-2042
Country : US
Telephone Number : 414-352-3100
Fax Number :
Provider Business Practice Location Address
First Line : 1640 E SUMNER ST
Second Line :
City : HARTFORD
State : WI
Zip : 53027-2684
Country : US
Telephone Number : 262-670-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 10/12/2023

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Directions to “ BRITTA BRADEN PA” Practice Location

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