MR. BRADEN STANG FNP NPI 1790359347

NPI Information

NPI: 1790359347
Provider Name: MR. BRADEN STANG, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1222 PRAY BLVD
WATERVILLE, OH
ZIP 43566
Phone: (419) 344-8176
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MR. Braden Stang, FNP is a family nurse practitioner in Waterville, OH with 3 years of experience. MR. Braden Stang, FNP NPI is 1790359347. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Graduation Year:2021

The provider's business location address is:

1222 PRAY BLVD
WATERVILLE, OH
ZIP 43566-717
Phone: (419) 344-8176

The NPI 1790359347 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/18/2021 and was last updated on 6/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN.440269	OHIO	No
2	363LF0000X	Nurse Practitioner	Family	4704377772	MICHIGAN	Yes
3	363LF0000X	Nurse Practitioner	Family	4704377772NSA210E8	MICHIGAN	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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