Provider Demographics
NPI:1639140726
Name:BRAUN, PAULA ELIZABETH (APRN)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ELIZABETH
Last Name:BRAUN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 ST THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-2914
Mailing Address - Country:US
Mailing Address - Phone:406-543-4008
Mailing Address - Fax:
Practice Address - Street 1:401 RAILROAD ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4178
Practice Address - Country:US
Practice Address - Phone:406-258-4789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2113194405363LP0808X
MT192058363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU006107029244101OtherINTERMOUNTAIN HEALTH CARE
UT94293834884101A013OtherCHAMPUS
UTU00197211319404001OtherBLUE CROSS
UTU002809517OtherDESERET MUTUAL
UTRCAR004662201OtherRAILROAD MEDICARE
UTU003942938348PB2OtherEDUCATORS MUTUAL
UTICARS72550OtherMEDICARE ADVANTAGE PLUS