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NPI Code Detail

MEDICARE: ELIZABETH BRAUER

MEDICARE: ELIZABETH BRAUER
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
1225X00000XOccupational Therapist6461-26WI

General Provider Information

NPI Number : 1841751583
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH BRAUER
Provider Business Mailing Address
First Line : 6508 FREDRICKSON RD
Second Line :
City : LENA
State : WI
Zip : 54139-9537
Country : US
Telephone Number : 920-373-1672
Fax Number :
Provider Business Practice Location Address
First Line : 2706 LINEVILLE RD
Second Line :
City : GREEN BAY
State : WI
Zip : 54313-7151
Country : US
Telephone Number : 920-662-7878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2019
Last Update Date : 05/06/2026

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