Provider Demographics
NPI:1548844624
Name:BRAATEN, CASSAUNDRA
Entity type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:
Last Name:BRAATEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11551 W KEN CARYL AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3873
Mailing Address - Country:US
Mailing Address - Phone:720-449-8055
Mailing Address - Fax:
Practice Address - Street 1:11551 W KEN CARYL AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3873
Practice Address - Country:US
Practice Address - Phone:720-449-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0006834363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant