MEDICARE: ANNABELLA MAXINE BRAUKER

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
1	374J00000X	Doula		MI

General Provider Information

NPI Number	:	1639906753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNABELLA MAXINE BRAUKER

Provider Business Mailing Address
First Line	:	2254 FRIENDSHIP DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5934
Country	:	US
Telephone Number	:	231-640-4114
Fax Number	:

Provider Business Practice Location Address
First Line	:	2254 FRIENDSHIP DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5934
Country	:	US
Telephone Number	:	231-640-4114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2024
Last Update Date	:	09/14/2024

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Directions to “ ANNABELLA MAXINE BRAUKER ” Practice Location

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