Ilene Brackin, PA-C
Physician Assistant, Surgical in Bismarck, ND. Individual provider (NPI-1).
NPI number1457451981
StatusActive
Last updated in NPPESDec 28, 2023
Details
- NPI
- 1457451981
- Entity type
- Individual (NPI-1)
- Name
- Ilene Brackin
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 24, 2006
- Certification date
- Dec 28, 2023
- Last updated
- Dec 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
| 363A00000X | Physician Assistant | PAC0236 | ND | |
| 363AS0400X | Physician Assistant, Surgical | PAC0236 | ND |
Practice location
310 N 10th StBismarck, ND 58501-4516
Phone 701-530-7500 · Fax 701-530-7484
Mailing address
310 N 10th StBismarck, ND 58501-4516
Phone 701-530-7500 · Fax 701-530-7484
Other practice locations
101 3rd Ave Sw
Minot, ND 58701-3880
Minot, ND 58701-3880
Phone 701-857-3655
2305 37th Ave Sw
Minot, ND 58701-7669
Minot, ND 58701-7669
Phone 701-857-5000
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