BRADEN LAWRENCE (NPI# 1104454123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104454123 |
| Entity Type | Individual |
| Full Name | BRADEN LAWRENCE |
| Credential | MD |
| Practice Address |
500 W Fort St # 111r Boise ID 83702-4501 |
| Mailing Address |
353 N Bella Via Pl Boise ID 83712-6731 |
| Practice Telephone | 2082490692 |
| Mailing Telephone | 2082490692 |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2020-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
500 W FORT ST # 111R |
| City | BOISE |
| State | ID |
| Zip Code | 83702-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649634718 | Elizabeth Ann Schackmann | Internal Medicine | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2016-04-05 |
| 1659909240 | Trevor Smith | Internal Medicine | 500 W Fort St # 111r, Boise, ID 83702-4599 | 2020-03-30 |
| 1396373148 | Irina Kratman | Student in an Organized Health Care Education/Training Program | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2020-03-28 |
| 1316575319 | Christina Topham | Student in an Organized Health Care Education/Training Program | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2020-03-27 |
| 1255969101 | David Yun | Internal Medicine | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2020-03-27 |
| 1194353169 | Aaron Spurlock | Student in an Organized Health Care Education/Training Program | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2020-03-27 |
| 1285297861 | Ryan Hirschi | Student in an Organized Health Care Education/Training Program | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2019-04-18 |
| 1720540784 | Dylan Mogk | Internal Medicine | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2019-04-01 |
| 1902368970 | Abdullahi Ibrahim Mohamed | Internal Medicine | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2019-04-01 |
| 1316408370 | Jared Cory Chin | Student in an Organized Health Care Education/Training Program | 500 W Fort St # 111r, Boise, ID 83702-4501 | 2019-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733694 | Susan L Boone | Student in an Organized Health Care Education/Training Program | 8506 W Donnybrook Dr, Boise, ID 83709-0606 | 2020-09-02 |
| 1730715855 | Madison Hiatt | Student in an Organized Health Care Education/Training Program | 1209 W Targee St, Boise, ID 83706-4565 | 2020-03-20 |
| 1053946202 | Kaitlyn Casper | Student in an Organized Health Care Education/Training Program | 267 W Arrowrock Ln, Boise, ID 83706-4802 | 2020-03-09 |
| 1952955825 | Lani Jo Hernandez | Student in an Organized Health Care Education/Training Program | 6200 N River Pointe Dr Apt B203, Boise, ID 83714-1848 | 2019-07-30 |
| 1033679865 | Bryce Ellis Turnbull | Student in an Organized Health Care Education/Training Program | 1128 S Garden Pl, Boise, ID 83705-5845 | 2019-03-20 |
| 1306331186 | Alexander Combs | Student in an Organized Health Care Education/Training Program | 5526 N Rothmans Ave, Boise, ID 83713-0950 | 2018-06-25 |
| 1528552031 | Matthew James Wolter | Student in an Organized Health Care Education/Training Program | 3145 S Falling Brook Ln, Boise, ID 83706-5205 | 2018-06-18 |
| 1376037218 | Avery Garner | Student in an Organized Health Care Education/Training Program | 12371 W Goldenrod Ave, Boise, ID 83713-0001 | 2018-06-14 |
| 1760914345 | Hugo Cesar Araujo Lino | Student in an Organized Health Care Education/Training Program | 869 E Holly St, Boise, ID 83712-7840 | 2017-04-01 |
| 1740711019 | Ryan James Blaser | Student in an Organized Health Care Education/Training Program | 912 W Hays St Apt 4, Boise, ID 83702-5461 | 2017-03-27 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.