Stephan Brautigam, CRNP | |
4 Princess Rd Ste 206, Lawrenceville, NJ 08648-2322 | |
(609) 482-3701 | |
Not Available |
Full Name | Stephan Brautigam |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 4 Princess Rd Ste 206, Lawrenceville, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215392550 | NPI | - | NPPES |
144400 | Other | PA | DOH-MH |
8963 | Other | NJ | DMHAS-MH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | SP015817 (Pennsylvania) | Primary |
Entity Name | Lifeback Of Pennsylvania Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457879520 PECOS PAC ID: 7517300775 Enrollment ID: O20240205004022 |
Mailing Address | Practice Location Address |
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Stephan Brautigam, CRNP 4 Princess Rd Ste 206, Lawrenceville, NJ 08648-2322 Ph: (609) 482-3701 | Stephan Brautigam, CRNP 4 Princess Rd Ste 206, Lawrenceville, NJ 08648-2322 Ph: (609) 482-3701 |
Yvette Slater, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2721 Brunswick Pike, Lawrenceville, NJ 08648 Phone: 609-882-2577 | |
Mrs. Katherine Soss Prihoda, RN,APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3131 Princeton Pike, Lawrenceville, NJ 08648 Phone: 609-896-2922 | |
Jacqualyn Gayle Curry, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2721 Brunswick Ave, Minute Clinic,, Lawrenceville, NJ 08648 Phone: 410-842-3680 | |
Andrea E Piscadlo, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 132 Franklin Corner Rd, Lawrenceville, NJ 08648 Phone: 609-896-4141 | |
Shameka Bussie-guest, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2721 Brunswick Pike, Lawrenceville, NJ 08648 Phone: 609-882-2577 | |
Beatrice Iloka, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2550 Brunswick Pike, Lawrenceville, NJ 08648 Phone: 609-396-8877 |