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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Braden Carl Andersen | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Braden | [sources] | |||
| Last name | Andersen | [sources] | |||
| Middle name | Carl | [sources] | |||
| NPI | 1598292120 | [sources] | |||
| Registration number | 95017246 · 95240117 | [sources] | |||
| Sector | Practical Nurse; Registered Nurse | [sources] | |||
| Address | 383 Dyer, Muldrow, OK, 74948 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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