KRISTINE BRAKER (NPI# 1679633580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679633580 |
| Entity Type | Individual |
| Full Name | KRISTINE BRAKER |
| Credential | NP |
| Practice Address |
118 W Maple Ave Beaver Dam WI 53916-2104 |
| Mailing Address |
1515 Park Ave Columbus WI 53925-1618 |
| Practice Telephone | 9203561000 |
| Mailing Telephone | 9206232200 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2985-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1679633580 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 301 W Main St, Marshall, WI 535599129 | 6086558181 |
| Street Address |
118 W MAPLE AVE |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588032767 | Holly Landry | Physical Therapist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2015-09-04 |
| 1093137416 | Prairie Ridge Health, Inc. | Surgery | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2014-01-21 |
| 1336425016 | Dean Health Systems, Inc | Durable Medical Equipment & Medical Supplies | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2011-10-26 |
| 1184933756 | Judy A Macdonald | Nurse Practitioner | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2010-09-30 |
| 1508029174 | Andrew T Tratar | Physician Assistant | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2008-07-03 |
| 1912077140 | Thomas Carl Smedberg | Orthopaedic Surgery | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-11-08 |
| 1467565978 | Family & Sports Orthopaedic Center, LLC | Specialist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| 1932212461 | Robert A Coe | Specialist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| 1366555815 | David C Barton | Specialist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| 1508979972 | Micheal E Ceizyk | Physical Therapist | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2006-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609994789 | Bluegrass Regional Healthcare | Nurse Practitioner | 1307 N Main St, Beaver Dam, KY 42320-8957 | 2007-03-27 |
| 1700872009 | Cynthia R Wilson | Nurse Practitioner | 1313 N Main St, Beaver Dam, KY 42320-8957 | 2005-09-22 |
| 1972598753 | Mary A Moore | Nurse Practitioner | 215 Corporate Dr, Suite B, Beaver Dam, WI 53916-3123 | 2005-09-16 |
| 1922000736 | Susan B Matthews | Nurse Practitioner | 1621 N Main St, Beaver Dam, KY 42320-8963 | 2005-08-11 |
| 1316941701 | Mary Ann Chambers | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2005-06-13 |
| 1871067553 | Chris Alan Thomas II | Nurse Practitioner | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2019-01-16 |
| 1215457288 | Courtney Nicole Keller | Nurse Practitioner | 1213 N Main St, Beaver Dam, KY 42320-8955 | 2017-06-21 |
| 1972973865 | Alelea B. Hewitt | Nurse Practitioner | 1520 N Main St, Beaver Dam, KY 42320-8960 | 2015-10-05 |
| 1134530769 | Lisa Drew | Nurse Practitioner | 110 Monroe St, Beaver Dam, WI 53916-2437 | 2014-05-16 |
| 1659700375 | Jennifer Shepard | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2013-11-04 |
| Find all providers in BEAVER DAM | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
Please comment or provide details below to improve the information on KRISTINE BRAKER.
| 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.